WO2017153956A1 - Uses of dental pulp stem cells expressing mesenchymal and neuronal markers and compositions thereof to treat neurological disease - Google Patents

Uses of dental pulp stem cells expressing mesenchymal and neuronal markers and compositions thereof to treat neurological disease Download PDF

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Publication number
WO2017153956A1
WO2017153956A1 PCT/IB2017/051404 IB2017051404W WO2017153956A1 WO 2017153956 A1 WO2017153956 A1 WO 2017153956A1 IB 2017051404 W IB2017051404 W IB 2017051404W WO 2017153956 A1 WO2017153956 A1 WO 2017153956A1
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Prior art keywords
hidpscs
cells
disease
stem cells
pharmaceutical composition
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PCT/IB2017/051404
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English (en)
French (fr)
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Irina Kerkis
Cristiane VALVERDE WENCESLAU
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Avita International Ltd.
Fundação Butantan
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Priority claimed from US15/065,259 external-priority patent/US11207352B2/en
Priority to RU2018134615A priority Critical patent/RU2742828C2/ru
Priority to CA3055398A priority patent/CA3055398A1/en
Priority to BR112018067969-0A priority patent/BR112018067969B1/pt
Priority to JP2018546882A priority patent/JP7008031B2/ja
Priority to IL261622A priority patent/IL261622B2/en
Application filed by Avita International Ltd., Fundação Butantan filed Critical Avita International Ltd.
Priority to EP17712549.9A priority patent/EP3426267B1/en
Priority to KR1020187028974A priority patent/KR102497999B1/ko
Priority to CN201780027504.4A priority patent/CN109219441B/zh
Publication of WO2017153956A1 publication Critical patent/WO2017153956A1/en
Priority to US16/125,702 priority patent/US11278574B2/en
Priority to US17/700,458 priority patent/US20220211765A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/32—Bones; Osteocytes; Osteoblasts; Tendons; Tenocytes; Teeth; Odontoblasts; Cartilage; Chondrocytes; Synovial membrane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/177—Receptors; Cell surface antigens; Cell surface determinants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
    • A61P21/02—Muscle relaxants, e.g. for tetanus or cramps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/08—Antiepileptics; Anticonvulsants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • A61P25/16—Anti-Parkinson drugs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • A61P27/06—Antiglaucoma agents or miotics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00—Drugs for immunological or allergic disorders
    • A61P37/02—Immunomodulators
    • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N5/00—Undifferentiated human, animal or plant cells, e.g. cell lines; Tissues; Cultivation or maintenance thereof; Culture media therefor
    • C12N5/06—Animal cells or tissues; Human cells or tissues
    • C12N5/0602—Vertebrate cells
    • C12N5/0652—Cells of skeletal and connective tissues; Mesenchyme
    • C12N5/0662—Stem cells
    • C12N5/0664—Dental pulp stem cells, Dental follicle stem cells

Definitions

  • This application relates to methods of producing stem cells, stem cells and compositions comprising stem cells suitable for the treatment of several diseases, especially neurological diseases, suitable for systemic administration.
  • Stem cell-based therapies are important in order to reconstruct morphological design and functional ability of neural tissue in damaged brain areas in patients. These therapies used to have a dual 0 role: transplanted stem cells paracrine action (anti-apoptotic, anti -inflammatory, anti-scar, anti-bacterial and angiogenic actions), which stimulates local cell survival, inhibits inflammation and brain tissue regeneration through the production of bioactive molecules acting in favor of new neurons production from the intrinsic and likely from donor stem cells.
  • the brain-derived neurotrophic factor is a gene responsible for BDNF protein expression found in the brain and spinal cord. This protein promotes the survival of nerve cells (neurons) by playing a role in the growth, maturation (differentiation), and maintenance of these cells. In the brain, the BDNF protein is active at the connections between nerve cells (synapses) where cell-to-cell communication occurs.
  • the BDNF protein helps regulate synaptic plasticity, which is important for learning and memory and is found to be expressed in regions of the brain that control eating, drinking, and body weight. Thus, BDNF has additional action in modulating all these functions.
  • synaptic dysfunction is a key pathophysiological hallmark in neurodegenerative disorders, including Alzheimer's disease.
  • BDNF neurodegenerative diseases
  • BDNF neurodegenerative diseases
  • Overdoses of BDNF could induce tumor formation in the brain; on the other hand low BDNF doses could not provide an efficient treatment.
  • Stem cells after transplantation are under the control of the patient biology, which can modulate BDNF secretion by the cells efficiently for each patient.
  • NSC transplanted nerve stem cells
  • NSC is generally difficult to access and cannot be obtained in sufficient therapeutic quantities to be applied in stem cell therapy through intravenous (IV) injection.
  • IV intravenous
  • two strategies are used to increase BDNF secretion.
  • this strategy has great limitations due to the fact that stem cells produce this factor only under in vitro conditions. Consequently, when such cells are transplanted to a patient they rapidly spend the "stock” of BDNF, which prevents long term treatment of neurodegenerative disease.
  • Another approach is to produce genetically manipulated stem cells which are suitably modified to overexpress BDNF. It is important to note that even NSC need to be genetically engineered to produce therapeutically sufficient levels of BDNF.
  • gene modification has its roots in gene therapy - an approach that still has to be proven. Therefore, there is a great need for new cell types and cell culture methods which can lead to stem cells with elevated secretion of BDNF.
  • the subventricular zone is the unique brain area where new neurons are produced throughout life (Altaian J and Das GD 1965) and in generating cells to function in repair through adulthood. Blood vessels immediately subjacent to the SVZ run parallel to the direction of tangential neuroblast migration, and guide migratory neuroblasts via BDNF signaling. It is now understood that the organization of the SVZ in the adult human brain differs significantly from that of any other studied vertebrates. Specifically, this region in the adult human brain contains a unique tape of astrocytes that proliferate in vivo and can function as NSC in vitro. Astrocytes in the central nervous system perform many important and diverse functions.
  • the neuro-vascular unit which is composed of a neuron, an astrocyte and a blood vessel.
  • Astrocyte processes extend to and interact with blood vessels.
  • Astrocytic endfeet are in intimate contact with the basal lamina that is a component of the vessel wall and together with endothelial cells they form the blood- brain barrier (BBB).
  • BBB blood- brain barrier
  • Dopamine (DA) is a major neurogenesis factor in the adult SVZ (Baker et al., 2004).
  • the proximity of the SVZ with the striatum makes it a neurodegeneration therapy target for striatum-neurodegeneration associated disorders such as Huntington's disease (HD) and Parkinson's disease (PD).
  • HD Huntington's disease
  • PD Parkinson's disease
  • Both pathologies are characterized by different clinical symptoms of motor dysfunction, and both are thought to involve the SVZ-striatum DA micro-circuitry path through different mechanisms.
  • the disease-generated DA innervation that occurs in HD is a natural protective feedback mechanism to compensate for the striatal internal neurons degeneration pathology caused by inherent genetic mutation (Parent M et al, 2013).
  • Dysregulation of DA receptor D2 is a sensitive measure for Huntington disease pathology in model mice (Crook et al., 2012; Chen et al., 2013).
  • PD is associated with massive degeneration of DA neurons, due to impaired neurogenesis in the nigrostriatal area and is a major cause of the pathology (Hoglinger et. al., 2004).
  • CI chronic inflammation
  • AD Alzheimer disease
  • AD chronic inflammation
  • a history of head injury and systemic infections are factors, which typically cause brain inflammation and are known to be risk factors for AD.
  • Excessive action of the brain's immune cells, which are glial cells is another hallmark of Alzheimer's disease.
  • inflammation is associated with injury and toxicity to neurons, the relationship among glial cells, neurons and amyloid plaques still remains unclear. Inflammatory mediators released by glial cells can be extremely toxic to neurons. Thus, they have been considered as mediators of neurodegeneration.
  • IL-12 and IL-23 Two closely related inflammation-promoting proteins, IL-12 and IL-23, are among those pumped out by microglia when the cells become immunologically active. The studies demonstrated that these proteins exist at elevated levels in the cerebrospinal fluid of AD patients. Blocking these inflammatory proteins in older Alzheimer's mice whose brains were already plaque-ridden reduced the levels of soluble, more toxic forms of amyloid beta and reversed the mice's cognitive deficits (Vom Berg et al., 2012; Griffin, 2013).
  • AD Alzheimer's
  • Aging may help trigger Alzheimer's by worsening common age-related problems with neurons, which become functionally deficient and lose their ability to transport and appropriately place proteins.
  • Inflammation worsens this problem by increasing the production of amyloid-beta in inflamed regions, stressing neurons, and hastening the age-related decline of their protein-transport and disposal systems.
  • Inflammation reactivates microglia into an inflammatory state and thus reduces their ability to clear up the brain (Swindell et al., 2013).
  • innate immune cell hyperactivity was detected through elevated IL-6 production in mutant mHTT expressing myeloid cells of the central (microglia) and peripheral innate immune system (monocytes and macrophages) both in HD patients and mouse models. It has also been reported that abnormally high levels of cytokines were present in the blood of people carrying the HD gene many years before the onset of symptoms (Bjorkqvist et al., 2008; Trager et al., 2014a, b). The composition of cytokines and levels of their expression, which can be measured in a blood of patients, could be useful to establish the need to initiate intervention for therapies as well as the timing of therapies.
  • Parkinson's disease is characterized by a slow and progressive degeneration of dopaminergic neurons in the substantia nigra.
  • Using animal models researchers have obtained consistent findings about involvement of both the peripheral and the central nervous system immune components in response to inflammation, which initiates an immune response in PD.
  • the presence of continuing and increasing pro-inflammatory mechanisms results in a process whereby cellular protective mechanisms are overcome and the more susceptible cells, such as the dopaminergic neurons, enter into cell death pathways, which leads to a series of events that are a crucial for the progression of PD (Doursout et al., 2013).
  • Neuroinflammatory processes might represent a target for neuroprotection, and antiinflammatory strategies may be one of the principal approaches in the treatment of PD.
  • Multiple approaches have been tested to repair neurodegeneration-associated CNS diseases, including clinical motor dysfunction diseases (Wernig M, et al., 2011).
  • Stem cells sources used for neuro-regeneration cell therapy include mesenchymal stem cells (MSC), neural progenitor cells (NP), human fetal neuronal stem cells (huNSC), and pluripotent stem cells (both embryonic (ESCs) and induced (iPSC)).
  • WO 2008/132722 and US Patent Application Publication No. 2013/0344041 disclose genetically manipulated stem cells to induce stem cell traits or to release neurotrophic factors
  • WO 2009/144718 and US Patent Applications Publication Nos. 2014/0335059 and 2014/0154222 disclose inducing the release of neurotrophic factors at levels higher than at non-induced stage via exposure to biological, natural or chemical compounds in culture
  • other studies use immortalized cell line of fetal stem cells that express early markers of neuronal differentiation.
  • IV intravenous
  • the present invention refers to immature dental pulp stem cells (IDPSCs).
  • the present invention refers human immature dental pulp stem cells (hIDPSCs) expressing CD44 and CD 13 and lacking expression of CD 146, obtained by method comprising: a) obtaining dental pulp (DP) from a human deciduous tooth; b) washing the DP with a solution containing antibiotics and placing the DP in a container with a culture medium; c) mechanically transferring the DP into another container with the culture medium after outgrowth and adherence of the hIDPSCs is observed to establish an explant culture; d) repeating steps b) and c) collecting hIDPSCs expressing CD44 and CD 13 and lacking expression of CD 146.
  • DP dental pulp
  • DP dental pulp
  • DP dental pulp
  • a solution containing antibiotics and placing the DP in a container with a culture medium
  • c) mechanically transferring the DP into another container with the culture medium after outgrowth and adherence of the hIDPSCs is observed to establish an explant culture
  • the present invention is directed human immature dental pulp stem cells (hIDPSCs) expressing CD44 and CD13 and lacking expression of CD146, HLA- DR, and HLA-ABC, obtained by the method comprising: a) obtaining dental pulp (DP) from a human deciduous tooth; b) washing the DP with a solution containing antibiotics and placing the DP in a container with a culture medium; c) mechanically transferring the DP into another container with the culture medium after outgrowth and adherence of the hIDPSCs is observed to establish an explant culture; d) repeating steps b) and c) to collect hIDPSCs expressing CD44 and CD13 and lacking expression of CD 146, HLA-DR, and HLA-ABC.
  • DP dental pulp
  • HLA-DR human deciduous tooth
  • HLA-ABC human immature dental pulp stem cells
  • the hIDPSCs are obtained by a method that further comprises: e) confirming expression of CD44 and CD13 and lack of expression of CD146 in the hIDPSC by immunostaining a sample of the hIDPSC to detect the CD44, CD13, CD146, HLA-DR, and/or HLA-ABC.
  • the immunostaining involves analysis of the sample with flow cytometry.
  • steps b) and c) are repeated more than 5 times and hIDPSC are collected from explant cultures produced after 5 transfers of the DP. In other embodiments, steps b) and c) are repeated more than 10 times and hIDPSC are collected from explant cultures produced after 10 transfers of the DP.
  • the explant culture comprises semi-confluent colonies of hIDPSCs.
  • the explant culture of hIDPSCs from step c) are passaged prior to collection.
  • passaging of the explant culture of hIDPSCs comprises enzymatic treatment of the hIDPSCs and transfer of the hIDPSCs to expand the explant culture.
  • the hIDPSCs of the present invention are obtained by a method comprising: extracting dental pulp (DP) from a tooth; culturing the DP in basal culture medium in a first container to establish a DP explant culture, wherein the DP explant culture is cultured without or with at least one extracellular matrix components selected from the group consisting of: fibronectin, collagen, laminin, vitronectin, polylysine, heparan sulfate proteoglycans, and enactin; mechanically transferring the DP to a second container to establish a second DP explant culture; repeating the step of mechanically transferring the DP until at least 15 DP explant cultures have been established; passaging the DP explant culture to produce a passaged DP culture; and combining the passaged DP culture of an early harvest population and an late harvest population to produce the pharmaceutical composition, wherein the early harvest population comprises passaged DP culture established from at least one of the first 15 DP explant cultures and the
  • the culturing step occurs under hypoxic conditions.
  • the step of combining the passaged DP culture of the early harvest population and the late harvest population to produce the pharmaceutical composition comprises: simultaneously thawing the frozen stock of passaged DP cultures of the early harvest population and the late harvest population; and pooling the thawed passaged DP culture to produce a pharmaceutical composition.
  • culturing the DP in basal culture medium in the method of production persists for at least three days before the DP is mechanically transferred.
  • the method of production further comprises creating a frozen stock of the passaged DP culture.
  • the frozen stock of the passaged DP culture is created at the third passage of the DP explant culture.
  • the invention is directed to hIDPSCs obtained by method comprising: extracting dental pulp (DP) from a tooth; culturing the DP in basal culture medium in a first container to establish a DP explant culture, wherein the stem cells comprising late harvest enriched from tissue of neural crest origin are double positive for CD44 and CD 13.
  • the stem cells enriched from tissue of neural crest origin and double positive for CD44 and CD13 are immature dental pulp stem cells (IDPSCs).
  • the invention is directed to is directed to hIDPSCs obtained by a method comprising: extracting dental pulp (DP) from a tooth; culturing the DP in basal culture medium in a first container to establish a DP explant culture, wherein the stem cells comprising late harvest enriched from tissue of neural crest origin demonstrated increasing level of secretion of endogenous BDNF and/or other neurotrophic factors (NF3, NF4 and NF5), when compared to stem cells obtained from early harvest.
  • the stem cells enriched from tissue of neural crest origin and secreting high level of endogenous BDNF and/or other neurotrophic factors (NF3, NF4 and NF5) are immature dental pulp stem cells (IDPSCs).
  • the hIDPSCs of the present invention are obtained by methods that produce hIDPSCs which express of CD44 and CD 13 and lack expression of CD 146 which enables the hIDPSCs to cross the BBB and/or lack of expression of CD 146, HLA-DR, and/or HLA-ABC which prevents rejection of the hIDPSCs by immune cells.
  • the hIDPSCs of the present invention are obtained by methods that produce stem cells expressing at least one safety marker selected from the group consisting of ATP-binding cassette sub-family G member 2 (ABCG2), p53, and inactive nanog.
  • Inactive nanog is expressed nanog localizing predominantly in the cytoplasm of the stem cell.
  • at least 75% of the stem cells express ABCG2, at least 75% of the stem cells express p53, or no more than 5% of the stem cells express inactive nanog.
  • Some stem cells further express the safety marker SOX2. In some such embodiments, no more than 30% of the stem cells express SOX2.
  • the hIDPSCs of the present invention are further obtained by methods that produce stem cells that may further secrete at least one marker selected from the group consisting of brain-derived neurotrophic factor (BDNF), neutrotrophin-3 (NT3), neutrotrophin-4 (NT4), neutrotrophin-5 (NT5), and p75.
  • BDNF brain-derived neurotrophic factor
  • NT3 neutrotrophin-3
  • NT4 neutrotrophin-4
  • NT5 neutrotrophin-5
  • p75 neutrotrophin-5
  • the stem cells of the pharmaceutical composition express BDNF, NT3, NT4, NT5, and p75 (CD271).
  • the hIDPSCs of the present invention are obtained by methods that produce stem cells that express at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • the stem cells produced by the methods of the present invention express BDNF, NT3, NT4, NT5, and p75. These cells may further express at least one safety marker selected from the group consisting of ABCG2, inactive nanog, p53, and SOX2.
  • at least 75% of stem cells express the at least one marker when the at least one marker is ABCG2.
  • at least 75% of the stem cells express p53.
  • no more than 5% of the stem cells express inactive nanog.
  • no more than 30% of the stem cells express SOX2.
  • the invention is directed to stem cells, wherein the stem cells comprise late harvest enriched from tissue of neural crest origin.
  • the tissue of neural crest origin is dental pulp.
  • the stem cells enriched from tissue of neural crest origin are immature dental pulp stem cells (IDPSCs).
  • IDPSCs immature dental pulp stem cells
  • Early harvest stem cells enriched from tissue of neural crest origin comprise IDPSCs of the first fifteen or the first 25 harvest cycles whereas late harvest stem cells comprise IDPSCs from the sixty or later or the 26th or later harvest cycle.
  • the invention comprises hIDPSCs which express of CD44 and CD 13 and lack expression of CD 146 which enables the hIDPSCs to cross the BBB and/or lack of expression of CD 146, HLA-DR, and/or HLA-ABC which prevents rejection of the hIDPSCs by immune cells.
  • the invention refers to stem cells expressing at least one safety marker selected from the group consisting of ATP-binding cassette sub-family G member 2 (ABCG2), p53, and inactive nanog.
  • Inactive nanog is expressed nanog localizing predominantly in the cytoplasm of the stem cell.
  • at least 75% of the stem cells express ABCG2, at least 75% of the stem cells express p53, or no more than 5% of the stem cells express inactive nanog.
  • Some stem cells further express the safety marker SOX2. In some such embodiments, no more than 30% of the stem cells express SOX2.
  • the stem cells of the presesent invention may further secrete at least one marker selected from the group consisting of brain-derived neurotrophic factor (BDNF), neutrotrophin-3 (NT3), neutrotrophin-4 (NT4), neutrotrophin-5 (NT5), and p75.
  • BDNF brain-derived neurotrophic factor
  • NT3 neutrotrophin-3
  • NT4 neutrotrophin-4
  • NT5 neutrotrophin-5
  • p75 p75
  • the stem cells of the pharmaceutical composition express BDNF, NT3, NT4, NT5, and p75 (CD271).
  • the stem cells of the present invention express at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • stem cells of the present invention express BDNF, NT3, NT4, NT5, and p75.
  • These cells may further express at least one safety marker selected from the group consisting of ABCG2, inactive nanog, p53, and SOX2.
  • at least 75% of stem cells express the at least one marker when the at least one marker is ABCG2.
  • at least 75% of the stem cells express p53.
  • no more than 5% of the stem cells express inactive nanog.
  • no more than 30% of the stem cells express SOX2.
  • the present invention is directed to compositions comprising hIDPSCs produced according to the methods disclosed herein.
  • the present invention is directed to a composition comprising the hIDPSCs disclosed herein.
  • the present invention relates to pharmaceutical compositions for use in the treatment of a neurological disease or condition selected from the group consisting of Parkinson's disease (PD), multiple sclerosis, epilepsy, amyotrophic lateral sclerosis (ALS), stroke, ischemia, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, Huntington's disease (HD), autism, schizophrenia, a motor disorder, and a convulsive disorder.
  • PD Parkinson's disease
  • multiple sclerosis epilepsy
  • ALS amyotrophic lateral sclerosis
  • stroke ischemia
  • autoimmune encephalomyelitis diabetic neuropathy
  • glaucomatous neuropathy Alzheimer's disease
  • Alzheimer's disease Huntington's disease (HD)
  • autism schizophrenia
  • schizophrenia a motor disorder
  • a motor disorder a convulsive disorder
  • the present invention further relates to pharmaceutical compositions for systemic administration to a subject to treat a neurological condition.
  • the neurological disease or condition may be a neurodegenerative disease or condition, autism, schizophrenia, epilepsy, stroke, ischemia, a motor disorder, or a convulsive disorder.
  • Neurodegenerative disease or condition may be Parkinson's disease (PD), multiple sclerosis, epilepsy, amyotrophic lateral sclerosis (ALS), stroke, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, or Huntington's disease (HD).
  • PD Parkinson's disease
  • multiple sclerosis epilepsy
  • stroke autoimmune encephalomyelitis
  • diabetic neuropathy glaucomatous neuropathy
  • Alzheimer's disease or Huntington's disease (HD).
  • PD Parkinson's disease
  • ALS amyotrophic lateral sclerosis
  • HD Huntington's disease
  • the present invention also relates to methods of using the hIDPSCs and/or pharmaceutical compositions of the present invention to treat neurological diseases or conditions.
  • the present invention also relates a method of treating a neurological disease or condition comprising administering to a subject the hIDPSCs and/or pharmaceutical compositions of the present invention.
  • the administration of the hIDPSCs and/or pharmaceutical compositions of the present invention is systemic and is administered to a subjet in need thereof.
  • such methods support the natural neuroprotective mechanism in subjects diagnosed with early HD or repairing lost DA neurons in subjects diagnosed with PD.
  • the methods may also be used as a preventive therapy for subjects at risk of HD.
  • the neurological disease or condition is treated by the stem cells and/or pharmaceutical compositions of the present invention crossing the blood/brain barrier (BBB) and inducing neurogenesis.
  • BBB blood/brain barrier
  • the hIDPSCs are directly transplanted into the brain parenchyma, including striatum, following crossing of the BBB.
  • the induced neurogenesis is dopamine-associated.
  • dopamine-associated neurogenesis occurs through self-differentiation of the stem cells or activation of migration and differentiation of intrinsic stem cells by the extrinsic stem cells.
  • massive dopamine-associated neurogenesis takes place in the subventricular zone (SVZ).
  • hIDPSCs and/or the pharmaceutical composition provide neuroprotection.
  • systemic neuroprotection is provided with the high basal level of neurotrophic and immunoprotective factors expression and release pattern of the stem cells of the pharmaceutical composition.
  • these stem cells of the pharmaceutical composition are IDPSCs.
  • the methods further comprise measuring the amount of DA receptor in the subject.
  • the DA receptor is receptor D2.
  • measuring the amount of DA receptor, for example receptor D2, in the subject comprises imaging the subject to detect presence of DA receptor.
  • the subject is administered a single administration or a first and second administrations of the pharmaceutical composition.
  • the repetitive (from 1 to six) administrations of the hIDPSCs and/or pharmaceutical composition take place at least seven days, at least 14 days, at least 21 days, or at least 30 days after the first administration, as well as one time per year, or twice per year.
  • administration of the hIDPSCs and/or pharmaceutical compositions is through intravenous injection.
  • the administration of the pharmaceutical composition may be repeated annually, for example, repeated three times.
  • the hIDPSCs and /or pharmaceutical composition comprising stem cells comprise stem cells that are autologous to the subject.
  • stem cells autologous to the subject are collected from the subject before disease manifestation from contingently "healthy cells", given that most of these diseases are genetic and age dependent.
  • the hIDPSCs and /or pharmaceutical composition comprising hIDPSCs that are allogeneic to the subject regardless of whether the major histocompatibility complex expressed by the stem cells match the major histocompatibility complex expressed by subject.
  • the pharmaceutical composition may also comprise a combination of stem cells that are autologous to the subject and stem cells that are allogeneic to the subject.
  • the present invention is directed to a method of preventing neuron loss in the central nervous system (CNS) of a subject, the method comprising administering to the subject hIDPSCs and/or a pharmaceutical composition comprising hIDPSCs, wherein the hIDPSCs express CD44 and CD 13.
  • CNS central nervous system
  • the present invention provides a method of promoting neuron cell growth and repair in the CNS of a subject, the method comprising administering to the subject hIDPSCs and/or a pharmaceutical composition comprising hIDPSCs, wherein the hIDPSCs express CD44 and CD 13.
  • the present invention is directed to a method of increasing expression of dopamine- and cAMP-regulated neuronal phosphoprotein (DARPP-32), dopamine receptor D2, and/or brain-derived neurotrophic factor (BDNF) in the CNS of a subject, the method comprising administering to the subject hIDPSCs and/or a pharmaceutical composition comprising hIDPSCs, wherein the hIDPSCs express CD44 and CD13.
  • DARPP-32 dopamine- and cAMP-regulated neuronal phosphoprotein
  • BDNF brain-derived neurotrophic factor
  • administration of the hIDPSCs and/or pharmaceutical composition is systemic.
  • the systemic administration is intravenous or intraperitoneal.
  • the present invention relates to hIDPSCs and/or a pharmaceutical composition comprising hIDPSCs expressing CD44 and CD 13 for use in the treatment of a neurological disease or condition selected from the group consisting of Parkinson's disease (PD), multiple sclerosis, amyotrophic lateral sclerosis (ALS), stroke, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, Huntington's disease (HD), autism, schizophrenia, stroke, ischemia, a motor disorder, and a convulsive disorder.
  • Parkinson's disease PD
  • multiple sclerosis amyotrophic lateral sclerosis
  • ALS amyotrophic lateral sclerosis
  • stroke autoimmune encephalomyelitis
  • diabetic neuropathy glaucomatous neuropathy
  • Alzheimer's disease Huntington's disease (HD)
  • autism schizophrenia, stroke, ischemia, a motor disorder, and a convulsive disorder.
  • the present invention is directed to the use of hIDPSCs and/or a pharmaceutical composition comprising hIDPSCs expressing CD44 and CD 13 for the treatment of a neurological disease or condition selected from the group consisting of Parkinson's disease (PD), multiple sclerosis, amyotrophic lateral sclerosis (ALS), stroke, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, Huntington's disease (HD), autism, schizophrenia, stroke, ischemia, a motor disorder, and a convulsive disorder.
  • Parkinson's disease PD
  • multiple sclerosis amyotrophic lateral sclerosis
  • ALS amyotrophic lateral sclerosis
  • stroke autoimmune encephalomyelitis
  • diabetic neuropathy glaucomatous neuropathy
  • Alzheimer's disease Huntington's disease (HD)
  • autism schizophrenia, stroke, ischemia, a motor disorder, and a convulsive disorder.
  • the present invention also relates to methods of using the hIDPSCsand/or pharmaceutical compositions of the present invention to prepare medicaments to treat neurological diseases or conditions.
  • FIG. 1 depicts immunophenotyping of hIDPSC from early and late harvests. Harvests
  • FIG. 2 depicts IDPSC at late harvest (13 harvests) and at passage 3.
  • the cells were immunopositive for P75 (CD271) (A, C, D), nestin (E-G), CD 13 (H) and CD73 (I), and they did not react with CD146 (J) and HLA-ABC (K).
  • FIG. 3 depicts in a) CFU-F assay performed in triplicate at T20, passage 3, demonstrating high clonogenic capacity of a LP population of IDPSCs.
  • LP early population
  • IDPSCs (batch #11) comprise approximately 80% cells that express BDNF and DARPP 32 while EP early population IDPSCs are negative for these markers (data not shown) and comprise a very low number of the cells which express D2.
  • FIG. 4A depicts positive immunostaining for BrdU (B-J) in control cells with a secondary antibody.
  • FIGs. 4B and 4C depict quantification of LP (late population) IDPSCs which react positively with a BrdU antibody.
  • A - Epi-fluorescence
  • B and
  • C - FACS analysis. Magnification
  • A - 200X.
  • B, E and H - 400X.
  • C,F,I,D,G and J - 1000X.
  • FIG. 5 depicts quantitative PCR for expression of endogenous Oct4, Nanog and Sox2 genes observed in hIDPSCs before (black color) and after reprogramming (white color) as well as in human embryonic stem cells (hESC) (striped).
  • FIG. 6 depicts the quantification of GFAP (glial fibrillary acidic protein) and beta-III- tubulin expression in EP (early population) and LP (late population) IDPSCs by flow cytometry.
  • GFAP glial fibrillary acidic protein
  • beta-III- tubulin expression in EP (early population) and LP (late population) IDPSCs by flow cytometry.
  • FIG. 7 depicts a flow cytometry analysis of EP (early population) and LP (late population) hIDPSC. Changes in CD146 and CD13 expression were observed following in vitro DP harvesting and hIDPSC passing. For EP-hIDPSC, -33% of CD 146 positive cells were observed, while for LP-hlDPSC, less than 1% of the cells were positive for this marker. For EP-hIDPSC -52% of CD13 positive cells were observed, while for LP-hlDPSC 95% of the cells were positive for this marker.
  • FIG. 8 depicts immunostaining of IDPSC isolated from dental pulp of C57BL-6 mice.
  • IDPSC are positive for Oct4 (A-B) with the expression mainly located in the nucleus.
  • the cells are also positive for Nanog, although the expression is limited in the (C).
  • Symmetrical division was observed in Nanog+ cells (D).
  • Two Sox2+ IDPSC and one Sox2- cell resulted from symmetric and asymmetric division (E).
  • A-C 200x.
  • D-G 400x.
  • FIG. 9 depicts the switch from symmetric to asymmetric neural stem cell divisions in the optic lobe.
  • FIG. 10 depicts the expression of undifferentiated LSCs and differentiated corneal cells proteins (as an example of limbal neuroectodermal lineage) in IDPSCs grown on plastic substrate for seven days in different culture media.
  • IDPSCs cultured in Epilife, DMEM/KO, KSFM, and SHEM culture media lacked expression of ABCG2 (A1-A4).
  • ABCG2 was detected in IDPSCs cultured in DMEM/F12, also known as basal culture medium (A5).
  • DMEM/F12 also known as basal culture medium (A5).
  • IDPSCs cultured in Epilife, KSFM, and DMEM/F12 lacked expression of CK3/12 (B l, B3, B5).
  • FIG. 11 depicts the expression of undifferentiated LSCs and differentiated corneal cells markers in IDPSCs grown during seven days in different culture media on amniotic membrane (AM).
  • Vimentin was detected in IDPSCs grown in DMEM/F12, SHEM, KSFM and DMEM/KO culture media (A and A1-A3).
  • ABCG2 was detected in IDPSCs grown in basal culture media and SHEM (B and B l) but not in IDPSC grown in KSFM and DMEM/KO (B2 and B3).
  • CK3/12 expression was not detected in IDPSC cultured DMEM/F12, SHEM and KSFM (C, CI, and C2).
  • FIG. 12 depicts pharmacological efficacy studies of investigational product CELLAVITATM (stem cells).
  • FIG. 13 depicts a scheme for the manufacturing process of compositions of IDPSCs comprising both early and late population IDPSCs suitable for the treatment of neurological diseases and conditions.
  • FIG. 14 depicts a time line of stability studies of hIDPSC during long term cryopreservation, following thawing and shipping before local of application in animal models of human diseases.
  • FIG. 15 depicts the timeline of the pilot study in the HD disease model.
  • HD was induced during the first four days, day 0 (DO) to day 4 (D4) by administering 3-NP.
  • D5 day 0
  • D5 day 5
  • IDPSC transplantation was administered via intravenous injection.
  • Animals were euthanized on day 9 (D9) followed by fixation of brain tissues and histological analysis of the lesions for the detection of IDPSCs biodistribution and engraftment (Vybrant + immunohistochemistry using specific antibodies).
  • FIG. 16 depicts the timeline for the Group I study in the HD disease model.
  • HD was induced during the first four days, day 0 (DO) to day 4 (D4).
  • D5 day 4
  • IDPSC transplantation was administered via intravenous injection. Animals were euthanized on day 35 (D35) followed by brain tissues fixation and histological analysis of lesion for detection of IDPSC biodistribution and engraftment (Vybrant + immunohistochemistry using specific antibodies).
  • FIG. 17 lists the "global biomarkers" (i.e. internationally-accepted) used for the evaluation of 3-NP-induced neurodegeneration process as well as the effect of IDPSCw transplantation on this process.
  • FIG. 18 depicts the localization of markers used for evaluation of neurodegeneration.
  • the red circles point to the usual locations of HD lesions and form scar tissue, which marked with positive expression of collagen I.
  • the expression of GABAergic and receptor D2 proteins can be observed.
  • Engraftment of hIDPSCs after IV administration is shown by detection of human nucleus using immunohistochemistry and by colocalization of CD73 and hIDPSC using immunofluorescence.
  • FIG. 19 depicts the engraftment of hIDPSCs after intravenous injection into the animals.
  • Optical cuts demonstrate at different depth of focus (A1-A4) the presence of hIDPSC stained with Vybrant (green), nuclei stained with PI (red).
  • the cells demonstrate capillary predominant association and different morphological types: neuron-like cells and pericytes (A6).
  • A2-A4 two pericytes at different location along capillary can be observed. Both present similar morphology.
  • embranchment of axon is also shown.
  • FIG. 20 depicts the engraftment of hIDPSCs four days after IV administration.
  • Optical cut demonstrates hIDPSC stained with Vybrant (green) and positively reacted with anti-hlDPSC antibody (red). Superposition of both produces yellow color.
  • the cells demonstrate near capillary localization.
  • Two markers for MSC were used: CD73 and CD 105 demonstrating positive reaction with hIDPSC (A-D).
  • FIG. 21 depicts immunohistochemistry results using anti-human nuclei (hNu) antibody. Few hIDPSCs cells can be observed in the cortex of the rat brain while multiple cells can be observed in the striatum. Light microscopy. 90X. Scale bars: 5 ⁇ (left) and 25 ⁇ (right).
  • FIG. 22 depicts immunohistochemistry results of the brain 30 days after IDPSCs injection using anti-human nuclei (hNu) anti-body.
  • the blue circles point to cells that present triangular neuron-like body.
  • the size of the triangular-bodied cells is indicative of the cells being "neurons.”
  • the white circle point to a fibroblast-like cell. Light microscopy. 90X.
  • FIG. 23 depicts immunohistochemistry results of the brain using anti-human nuclei (hNu) anti-body.
  • hNu anti-human nuclei
  • FIG. 23 depicts immunohistochemistry results of the brain using anti-human nuclei (hNu) anti-body.
  • hIDPSCs localized in striatum and in SVZ are shown.
  • FIG. 24 depicts positive DARPP32 immunostaining for neurons in CELLAVITATM (stem cells)-treated animals 30 days after hIDPSC transplantation
  • A, B Untreated animals (3-NP + saline) showing no DARPP32 immunostaining in the striatum or cortex.
  • C, D Rat neuron production in the cortex and striatum of hIDPSC-treated animals. Circled in blue, area with neurons in (C) and higher magnification in (D). Light microscopy. Magnification: 20X and 90X.
  • FIG. 25 depicts the expression of receptor D2 in the striatum of HD rat model before administration of IDPSC and 30 days after administration of IDPSC.
  • Samples from animals with scores 3 and 2 are of animals treated with 3-NP but did not receive IDPSC treatment. In the score 2 sample, only a few receptor D2 positive cells could be observed while no such cells could be observed in the score 3 sample.
  • Sample from animals with score 1 is of an animal treated with 3-NP and IDPSC. In the score 1 sample, multiple receptor D2 positive cells could be seen. Inset high magnification demonstrated the details of immunostaining and neuron morphology.
  • FIG. 26 depicts the experimental design for Group II and III in order to study the effects of multiple IDPSC transplantations and elevated cell doses in HD disease model.
  • FIG. 27 depicts an example scheme of how to determine the extent of motor deterioration in rats with HD induced by 3-NP.
  • FIG. 28 depicts the body weight of pilot study animals before 3-NP induction, after 3-
  • NP induction day 4
  • IDPSCs day 4
  • hIDPSCs after treatment with IDPSCs
  • FIG. 29 depicts the body weight of Group II and Group III animals before 3-NP induction and after 3-NP induction.
  • FIG. 30 depicts the body weight of Group II animals after 3-NP induction and 30 days after treatment with hIDPSCs.
  • FIG. 31 depicts the body weight of Group III animals after 3-NP induction and 30 days after treatment with hIDPSCs.
  • FIG. 32 depicts the timeline of the pilot study in the HD disease model (groups I, II, III, and IV).
  • HD was induced during the first four days, day 0 (DO) to day 4 (D4) by 3-NP.
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • D5 day 0
  • IDPSC transplantation was administered via intravenous injection. Animals were euthanized on day 9 (D9) followed by brain tissue fixation and histological analysis of lesion for detection of IDPSC biodistribution and engraftment (Vybrant + immunohistochemistry using specific antibodies).
  • Group I and III were euthanized on day 35 (D35) and groups II and IV on day 95 followed by brain tissues fixation and histological analysis of lesion for detection of IDPSC biodistribution and engraftment (Vybrant + immunohistochemistry using specific antibodies).
  • FIG. 33 presents localization of hIDPSC in rat brain tissue four days after hIDPSC administration.
  • hIDPSC cells were stained green (Vybrant) and nuclei were stained red (PI) (A1-A4).
  • Cells were localized mainly in capillaries and two morphological types were observed: neuron-like cells and pericytes. Note the different localization of pericytes in capillaries in A2, A3, and A4; in A4, hIDPSCs are localized in the axon bifurcation.
  • A5 neuron morphology in brain tissues (A2-A4);
  • FIG. 34 depicts the engraftment of hIDPSCs four days after IV administration.
  • Optical cut demonstrates hIDPSC stained with Vybrant (green) and positively reacted with anti-hlDPSC antibody (red). Superposition of both produces yellow color.
  • the cells demonstrate near capillary localization.
  • Two markers for MSC were used: CD73 and CD 105 demonstrating positive reaction with hIDPSC (A-D).
  • FIG. 35 depicts immunohistochemical images showing positive anti-human nuclei (hNu) staining of hIDPSCs and their localization in rat brain tissue 30 days after hIDPSC administration. Note: A few hIDPSCs in the cortex (left) and a large number of hIDPSCs in the corpus striatum (right). Light microscopy. 90X magnification. Scale bars: 5 um and 25 ⁇ , respectively.
  • FIG. 36 shows an immunohistochemical image of rat brain tissue after the injection of 3-NP and the administration of hIDPSC. Note: positive anti-human nuclei (hNu) immunostaining in cells. Neuron-like cells are circled in blue, and fibroblast-like cells are circled in white. Light microscopy, 90X magnification.
  • hNu positive anti-human nuclei
  • FIG. 37 depicts Nissl Staining in the Striatum of Untreated Animals (3-NP + saline) (a-bl); Control Animals (no 3-NP or hIDPSC) (c, cl); and Treated Animals (3-NP + hIDPSC) (d-fl).
  • score 1 (a, al, d, and dl); score 2 (b, bl, e, and el); and score 3 (c, cl, f, and fl).
  • FIG. 38 depicts DARPP32 immunostaining in the corpus striatum of untreated animals (3-NP + saline) (a- b), Controls (no 3-NP or hIDPSC) (c), and Treated Animals (3- NP + hIDPSC) (d-e l).
  • no immunostaining blue arrow, score 1
  • score 2 few DARPP32+ cells
  • score 3 Control animals
  • neuron loss in Treated animals (3-NP + hIDPSC)
  • score 2 black arrow
  • FIG. 39 depicts neuronal growth in the striatum of rats after hIDPSC.
  • Administration of hIDPSC resulted in a neuroreparative effect in hIDPSC-treated animals by (A) Nissl staining and (B) DARPP32 expression.
  • C Number of animals showing neuron recovery after hIDPSC administration compared to the Controls. Most hIDPSC-treated animals (3-NP + hIDPSC) had scores 3 and 2 (moderate and mild), whereas most Untreated animals (3 NP + saline) had scores 2 and 1 (severe and moderate).
  • FIG. 40 depicts BDNF expression in rat brain tissue after (a-f) 3-NP injection and
  • FIG. 41 depicts DARPP32 expression in the striatum of rats 30 days after CELLAVITATM (stem cells) administration in a 3-NP model of HD. Confocal microscopy, overlapping images in A. Epifluorescence + Digital interference contrast (DIC) microscopy. B-D: Epifluorescence. Scale bar: 10 um.
  • FIG. 42 depicts the effect of hIDPSC administration on body weight in treated (3-NP
  • FIG. 43 depicts representative figures of BDNF expression in the brain of 3-NP treated animals 4 days after hIDPSC intravenous transplantation. Strong BDNF secretion observed in cortex (la,lb). Lower BDNF secretion showed in hippocampus (lc,ld). Strong BDNF expression observed in striatum (le, If). Control 3-NP group did not show BDNF secretion in the same brain regions (2a-2f). Light microscopy. Magnification 20X in la, lc, le, 2a, 2c, 2e; Magnification 40X in lb, Id, If, 2b, 2d, 2f. Arrows in lb and Id and asterisks in le and If demonstrate BDNF secreting cells.
  • FIG. 44 depicts representative BDNF expression in the brain of 3-NP treated animals 30 days after hIDPSC intravenous transplantation. Strong BDNF secretion was observed in cortex (la, lb). Lower BDNF secretion was observed in the hippocampus (lc, Id). Strong BDNF expression was observed in the striatum (le, If). The control 3-NP group did not show BDNF secretion in the same brain regions (2a-2f). Light microscopy. Magnification 20X in la, lc, le, 2a, 2c, 2e; Magnification 40X in lb, Id, If, 2b, 2d, 2f. Arrows in lb and Id and asterisks in le and If demonstrate BDNF secreting cells.
  • FIG. 45 depicts the experimental designs for all HD disease model studies in order to evaluate functional characteristics of HD-induced rats after IDPSC transplantation.
  • FIG. 46 depicts the principle difference between normal MSC and ES (or iPS) cells.
  • Tumor formation is correlation with ES and iPS cells but not with normal MSC.
  • FIG. 47 depicts a scheme for the mechanism of the efficacy of hIDPSC in inducing neurogenesis and providing neuroprotection.
  • FIG. 48 depicts an early phase development process for CELLAVITATM (stem cells) isolation and batch formulation.
  • FIG. 49 depicts another early phase development manufacturing process for CELLAVITATM (stem cells).
  • FIG. 50 depicts a CELLAVITATM (stem cells) production process composed of several major steps.
  • FIG. 51 depicts safety studies of investigational product CELLAVITATM (stem cells).
  • the term "high expression” in reference to the expression level (strongly immunopositive for antigen of interest) of a gene in a population of cells refers at least 75% of the population expressing the gene.
  • low expression in reference to the expression level of a gene in a population of cells refers no more than 30% of the population expressing the gene. In preferred embodiments, low expression refers no more than 25% of the population expressing the gene.
  • no expression in reference to the expression level of a gene in a population of cells refers no detectable cells that express the gene of interest in the population. No detectable expression includes an expression level that is within the realm of error for the method of measuring expression.
  • the term "subject" or “patient” refers to any vertebrate including, without limitation, humans and other primates (e.g., chimpanzees and other apes and monkey species), farm animals (e.g., cattle, sheep, pigs, goats and horses), domestic mammals (e.g., dogs and cats), laboratory animals (e.g., rodents such as mice, rats, and guinea pigs), and birds (e.g., domestic, wild and game birds such as chickens, turkeys and other gallinaceous birds, ducks, geese, and the like).
  • the subject may be a mammal. In other implementations, the subject may be a human.
  • stem cell refers immature, unspecialized cells that, under certain conditions, may differentiate into mature, functional cells.
  • neural stem cell or “NSC” refers to multipotent cells that self-renewable and able to terminally differentiate into neurons, astrocytes, and oligodendrocytes.
  • neural progenitor cells refer to undifferentiated cells further along the stage of cell differentiation than neural stem cells. Thus these cells are derived from neural stem cells and can produce progeny that are capable of differentiating into more than one cell type of central nervous system (CNS) and peripheral nervous system (PNS).
  • CNS central nervous system
  • PNS peripheral nervous system
  • neural precursor cell refers to a mixed population of cells consisting of neural stem cells and all of its undifferentiated progeny. Therefore NPCs include both NPC and NSC.
  • the NPCs can also be categorized into neuronal NPCs and glial NPCs, which produce neurons and glial cells, respectively. .
  • the term "harvest cycle” constitutes a transfer of the orgao (e.g. of neural crest origin like dental pulp) or tissue to a new cell culture container after adherence and outgrowth of the stems cells in the tissue followed by preservation (e.g. cryopreservation) and/or sub-culturing of the outgrowth of IDPSCs.
  • orgao e.g. of neural crest origin like dental pulp
  • tissue e.g. of tissue
  • preservation e.g. cryopreservation
  • sub-culturing of the outgrowth of IDPSCs e.g. cryopreservation
  • stem cells from human exfoliated deciduous teeth cannot be divided in early and late population, as these cells are isolated using enzymatic method only once from dental pulp, which are discarded after SHED isolation. Thus, only one SHED cell population can be isolated. Further, following enzymatic digestion, SHED can be passed from one to other cell culture flask thus counting cell passages, which generally are performed when SHED reach semi-confluence.
  • IDPSCs can be isolated as from explant culture of the dental pulp after the first adherence of DP to plastic and cells outgrowth - early population cells. At this stage dental pulp is not discarded and used for subsequent explant dental pulp cultures - late populations. Thus, IDPSC isolated from the second or later harvest cycle are late population cells. For example, IPDSCs that are isolated from the second harvest cycle or later are late population undifferentiated stem cells.
  • the term "early passage” refers to the cells from the first five passages of an explant culture.
  • late passage refers to the cells from passages after the fifth passage, e.g. in the sixth passage or later, of an explant culture.
  • the IDPSC may be from an early or late population and additionally categorized as an early or late passage.
  • the present invention relates to the discovery that a particular composition of IDPSC, the unique stem cells population, which composed by early and late stem cells populations, from tissue of neural crest origin can cross the blood/brain barrier (BBB) and induce neurogenesis.
  • Tissue of neural crest origin include, for example, dental, periodontal, and hair follicular tissue.
  • Hair follicular tissue includes follicular tissue of the vibrissa.
  • the hIDPSC was evaluated in the 3-NP (three nitropropionic acid) HD rat model.
  • the hIDPSC showed engraftment into the rat brain after 1 month following intravenous injection of lxlO 6 and lxlO 7 cell/transplant (3xl0 6 ceh7kg and 3xl0 7 cell/kg) labeled with fluorescent protein (Vibrant), as well as, following immunohistochemistry analysis using specific anti- human antibody. Cell engraftment was observed in different brain compartments (cortex, striatum and Subventricular zone-SVZ).
  • the ability to cross the BBB enables systemic administration (e.g. IV administration) of stem cell therapy to treat neurological conditions, which provides a significant advantage over more localized methods of administration.
  • systemically administration being less invasive, leaving stem cells to migrate to locations that require aid reduces the risk of harmful cell masses developing at the site of administration.
  • intrathecal (IT) administration of stem cell therapy is commonly contemplated in preclinical and clinical studies, this method can have significant risk when the stem cells are MSCs.
  • the composition of IDPSC may be in the form of a pharmaceutical composition comprising stem cells expressing a mesenchymal and neuroepithelial stem cell immunophenotypes.
  • expressing a mesenchymal and a neuroepithelial stem cell molecular profile is the expression of markers of MSC and neuroepithelial cells/progenitor cells and genes encoding neuro-protective and immuno- protective factors.
  • Cells expressing a MSC immunophenotype include expression of CD44.
  • Prior animal models of multiple sclerosis found that NCS adhesion to inflamed endothelial cells and then trans-endothelial migration across the BBB into the inflamed CNS areas are sequentially mediated by the constitutive expression of functional cell adhesion molecules (CAM), especially CD44 (Rampon C et al., 2008).
  • CAM functional cell adhesion molecules
  • CD44 functional cell adhesion molecules
  • Perycites are known to play a critical role in the integration of endothelial and astrocyte functions at the neurovascular unit, and in the regulation of the BBB (Armulik et al., 2010; Liu et al, 2012).
  • MSC mesenchymal stem cells
  • CD44 which is a ligand of E and L blood vessel endothelial selectins
  • MSC present similar homing mechanisms as leukocytes.
  • the first step of leukocyte migration involves capture of leukocytes flowing freely in the blood stream, mediated by glycoproteins known as selectins.
  • P-and E-selectins are expressed by the vascular endothelium and are the principal mediators for the rolling response in leukocyte migration through blood vessels (Luster et al., 2005). MSC may use this or similar mechanisms to engraft in several organs (Sackstein et al., 2008) such as the brain. Thus, CD44 is considered a pivotal factor for MSC migration into the brain. Similarly to BM MSC, hIDPSC express CD44, which suggests that CD44 is also involved in hIDPSC migration towards several organs (Barros et al., 2014, Castanheira et al, 2013) including the brain after intravenous administration.
  • hIDPSC express also CD 13, (aminopeptidase N) (Kerkis et al., 2006; Kerkis and Caplan, 2012), which is multifunctional protein and plays varying roles in cell migration, cell proliferation, cell differentiation (Taylor et al., 1993; Mina-Osorio et al, 2008a/b).
  • CD13 participates in angiogenesis generating and modulating angiogenic signals, in the process of capillary tube formation, and as a marker of angiogenic vessels (Bhagwat et al., 2001). This suggests its possible role in hIDPSC capacity to migrate and to target brain vasculature. In the 3-NP rat study, hIDPSC demonstrated tight association with brain capillaries.
  • the IDPSC lack expression of CD 146, HLA-DR, and/or HLA-
  • hIDPSC hIDPSC
  • S-Endo 1 antigen CD 146
  • MCAM CD146
  • T cells 3%) in the peripheral circulation of healthy individuals.
  • MCAM positive T cells demonstrate an increased ability to bind to endothelial monolayers and these cells could represent early components of the adaptive immune response (Dagur et al, 2015). Therefore, stem cells, which express this marker may bind to BBB and not cross BBB, as well as being immune reactive.
  • the mesenchymal stem cell genotype pattern also includes low expression of pluripotent markers OCT3/4 and nanog.
  • the undifferentiated stem cells of pharmaceutical composition of the invention need not express c-Myc, KLf-4, and REX-1. In fact, these stem cells may be negative for c-Myc, KLf-4, and REX-1.
  • Stem cells expressing a neuroepithelial stem cell molecular profile express at least one, preferably two, more preferably more than two NPC- and NSC-biomarkers selected from the group consisting of vimentin, nestin, SOX2, p75, and other neurotrophic factors essential for neural cells development and survival.
  • p75 is a neurotrophic receptor marker.
  • BDNF brain-derived neurotrophic factor
  • BDNF brain-derived neurotrophic factor
  • GNDF glial cell line-derived neurotrophic factor
  • NGF nerve growth factor
  • NTs neurotrophins
  • BNDF plays a critical role in Huntington's disease (Gauthier et al.; Strand et al.) and Parkinson's disease (Mogi et al), both of which are dopamine -associated neurodegenerative diseases.
  • NTs essential for neuronal development and survival include NT3, NT4, or NT5.
  • NT4 and NT5 are known to promote sensory and motor axon growth.
  • the stem cells comprise cells autologous to a subject in need of the pharmaceutical composition. In other implementations, the stem cells comprise cells allogeneic to the subject in need of the pharmaceutical composition. In some implementations, stem cells comprise a combination of cells autologous to and allogeneic to the subject in need of the pharmaceutical composition.
  • the composition of stem cells is isolated from tissue of neural crest origin selected from the group consisting of dental tissue, periodontal tissue, and hair follicular tissue.
  • tissue of neural crest origin is dental pulp.
  • the stem cells are from immature dental pulp, for example, human immature dental pulp stem cells (IDPSCs) as disclosed in International Application no. PCT/IB14/59850 and U.S. Patent Application No. 14/2140,016. IDPSCs cany multiple neuronal markers and undergo robust differentiation into neurons.
  • IDPSCs human immature dental pulp stem cells
  • IDPSC immunophenotype is unexpected expression of these markers and at the same time markers typical for MSC, presenting immunophenotype in accordance with the International Society for Cellular Therapy's minimal criteria for defining multipotent mesenchymal stromal cells (Dominici et al., 2006).
  • This combination of expression by IDPSC of MSC and multiple neuronal markers is not typical for MSCs (Dominici et al, 2006) and which has not been disclosed for MSCs.
  • compositions contemplated in the invention are preferably isotonic.
  • the population of immature stem cells should be between 10 4 - 10 10 cells per injection, for example, 10 4 , 10 5 ,10 6 and 10 7 cells per kg of body weight.
  • the pharmaceutical composition comprising a population of stem cells may be used in adjunction to other pharmaceutically active compounds or modalities.
  • the pharmaceutical composition may further comprise another pharmaceutically active compound or therapeutic modality.
  • MSCs are found in bone marrow, umbilical cord tissue, dental pulp and fat pads.
  • bone marrow MSCs are relatively rare, comprising only one out of every 10,000 cells, while other sources are significantly richer in these cells.
  • MSCs are responsible for tissue regeneration in cases of disease, trauma or injury throughout human life. This function of MSCs is mediated by their capacities for self-renewal and plasticity (the capacity for differentiation - production of diverse cell types).
  • MSCs can be isolated from aforementioned tissues and cultured easily in the laboratory. After obtaining a limited number of the cells from a patient, MSCs can be multiplied rapidly in vitro and cryopre served for the future clinical applications.
  • MSCs are able to secrete a variety of bioactive molecules, such as cytokines, which provide "trophic activities" by structuring a regenerative microenvironment, and other molecules that contribute to immunomodulatory cell functions and even to transfer products as large as mitochondria to damaged cells that need help.
  • cytokines which provide "trophic activities" by structuring a regenerative microenvironment
  • MSCs in response to chemotactic stimuli can migrate to the focal injury from both local and surrounding sites. Additionally, MSCs can act to reduce chronic inflammation, to inhibit apoptosis, to provide the appearance of myofibroblasts, to inhibit scar formation and to stimulate the mitosis of tissue-intrinsic progenitors, thus remodeling damaged tissue.
  • MSCs are also called “Medicinal Signaling Cells.” They stimulate angiogenesis, the process of new blood vessel formation, which is closely linked to neurogenesis, the process by which new nerve cells are produced. Blood vessels play an important role as a framework for neuronal progenitor cells migration toward the damaged brain region The factors secreted by MSCs also reduce the destructive effects of oxidative harm. Using all these mechanisms of action MSCs can significantly improve lesioned microenvironment that leads to restoration of the damaged cells. Therefore, MSCs are believed to be "cellular paramedics”.
  • MSCs obtained from humans were labeled, in order to track them, and injected into mice that had some type of tissue damage, they migrated throughout the damaged tissues apparently evenly. These cells can or not to be present in the tissue for a substantial period of time, which depends on disease model. The continued presence of MSCs is important, but not essential, to therapeutic development because it indicates that potential positive long-term effects of a treatment might be capable of persisting.
  • MSCs suppress the immune system and reduce inflammation.
  • MSCs can be transferred between organisms demonstrating very low immune rejection, which occurs when the immune system of the organism attacks the foreign tissue, receiving the transplant. This finding makes MSCs good candidates for transplantation or injection into a host because they can avoid rejection by the host's immune system (Le Blank, Ringden, 2006; English, 2012; Miguel et al., 2012; Griffin et al., 2012; Ankrum et al., 2014).
  • the crucial question of cellular therapies is a route of MSCs delivery into the brain, which has been approached in a number of different ways.
  • Several approaches have been proposed to deliver MSCs into the brain such as, intrathecal, intravenous, an injection into the space surrounding the spinal cord and even a route through the nose.
  • the blood/brain barrier (BBB) is formed and it controls selective molecular or cells trafficking between the bloodstream and brain interstitial space.
  • the BBB present significant problems for the delivery of therapeutic agents (drugs or cells) for treating brain malignancies and neurodegenerative disorders.
  • Systemically-infused MSCs may treat acute injuries, inflammatory diseases, stroke of the central nervous system (CNS) and even brain tumors because of their regenerative capacity and ability to secrete trophic, immune modulatory, or other engineered therapeutic factors.
  • CNS central nervous system
  • MSCs possess the ability to migrate across the BBB in normal and pathological conditions remains unresolved (Liu et al., 2013).
  • MSCs can support repair neurodegeneration by secreting trophic factors, which are proteins that stimulates differentiation and survival of cells.
  • trophic factors proteins that stimulates differentiation and survival of cells.
  • the effects of these factors allow nerve cells to carry out several processes that can support survival: axon extension, growth, and cells attachment.
  • the number of cells used in these experiments varied from 10 5 , 2 x 10 5 , 4 x 10 5 , 5 x
  • the present invention provides a method of treating neurological diseases and condition that uses a unique population of IDPSC having the immunophenotype typical for MSCs as defined by the International Society for Cellular Therapy effective even with a minimally invasive administration, for example through classic IV route of delivery.
  • IDPSC immunophenotype typical for MSCs as defined by the International Society for Cellular Therapy
  • stem cells Unfortunately, only treatment with administering fetal donor tissue to the striatum proceeded to clinical trial, and it was only a small trial.
  • Stem cell therapy is inevitable since intracellular and cellular mechanisms are involved into HD phenotype. Stem cell therapy may also accelerate the process of brain tissue regeneration. Stem cells are an important therapy, which will help to rebuild an area of the brain that was most damaged in HD. Only drugs approach will not be able to reconstruct damaged brain areas especially in late stages of HD.
  • MSCs may be obtained from extracted human teeth, both permanent and deciduous, by enzymatic digestion (Gronthos et al. 2000; Miura et al., 2003), or by organ culture followed by explant (immature dental pulp stem cells, IDPSCs) technology as disclosed in International Application no. PCT/IB 14/59850 and U.S. Patent Application No. 14/2140,016.
  • the IDPSCs are obtained from dental pulp tissue, which anatomically originated from ectomesenchymal tissue, more precisely from neural crest, which is a mass of tissue present in the early formation of an embryo. It eventually forms the hard and soft tissues of the neck and cranium.
  • IDPSCs which are of neural crest origin, are known to migrate pre-natally into various, mainly ectodermal tissues and have the capacity to self-renewal and display a developmental potential almost the same as embryonic stem (ES) cells, but without risk of formation of embryonic bodies in vitro and teratomas in vivo (Kerkis and Caplan, 2012).
  • the postmigratory stem cells of neural crest origin generate all craniofacial bones, the majority of cells and tissues of the central and peripheral nervous systems, as well as several non-neural cell types, such as smooth muscle cells of the cardiovascular system, pigment cells in the skin, cartilage, connective tissue, corneal epithelium and dental pulp among them.
  • postmigratory postnatal stem cells of neural crest origin are of restricted developmental potential, they maintain functional characteristics resembling their embryonic counterparts and an ability to differentiate into a broad spectrum of cell types (Le Douarin et al., 2004, 2007, 2008; Dupin et al., 2007; Le Douarin & Dupin, 2003, 2012).
  • IDPSCs In vitro IDPSCs undergo uniform differentiation into neurons and glial cells. In vivo transplantation of human IDPSCs showed dense engraftment in various tissues, including neurons. Neuronal fate differentiation is based upon epigenetic "memory" of orofacial bones, including dental pulp, compared with those in axial and appendicular bone (bone marrow and ileac crest) based on their different embryological origins. Maxillas, mandible, including the alveolar bone (i.e. dentine, dental pulp and periodontal ligament), are formed exclusively by neural crest cells while axial and appendicular bones develop from mesoderm. Thus IDPSCs have the potential for neural regeneration and neuroprotection.
  • transplantation Unless the transplant is an autograft, there is always a risk that the host's immune system will attack the transplant. Even a well-matched allograft requires immunosuppression pretreatment. This remains true for stem cell transplantation.
  • the therapeutic stem cell population should be not be immunogenic. Immunogenicity is the ability of allogeneic stem cells to provoke an immune response when facing the host immune system after transplantation (Schu S et al., 2012).
  • MHC major histocompatibility complex
  • mice with mouse hepatitis virus- induced CNS demyelination resulted in increased T cell infiltration and NPC rejection (Weinger JG et al., 2012).
  • MHC major histocompatibility complex
  • recent evidence supports the possibility that undifferentiated adult stem cells are endowed with an immunologically privileged status and are capable of escaping the normal processes of allogeneic rejection (Bifari F et al. 2010).
  • Immunologically privileged status is possible for a population of cells if the cells lack the expression of MHCs.
  • no immunogenicity in humans can occur by the population of stem cells being essentially negative for human leukocyte antigen (HLA), which is the human version of MHC. Therefore, the absence of HLA-DR, which is a quality control characteristic of IDPSCs is an essential marker for cell to be used in for systemic cell therapy without need of toxic immunosuppression pre-treatment to the patient.
  • HLA human leukocyte antigen
  • Another risk of stem cell transplantation is the increased risk of tumor development, especially for undifferentiated cells, because of these cell's potential for differentiation into other cell types.
  • Pluripotent stem cells especially hESCs and iPSCs cells are able to form spheres that resemble embryoid bodies in vitro and teratomas in vivo. All currently available technologies to apply pluripotent cells hold tumorigenicity risk. Expression and lack of expression of certain genes reduces risks to enable systemic administration of a population of stem cells.
  • Nanog is transcription factor associated with the maintenance of the pluripotent cells of the inner cell mass and the formation of embryonic stem cells.
  • Nanog is a leukemia inhibitory factor (LIF) and activator of transcription-independent factor-3 (STAT-3). It is regulated by OCT4 and SOX2 and in turn positively regulates the expression of OCT4, SOX2 and itself by binding to the respective promoter gene regions (Boyer et al, 2005; Loh et al., 2006; Li, 2010). Together, these three transcription factors play an essential role in preventing differentiation of pluripotent stem cells (Boyer et al., 2005).
  • LIF leukemia inhibitory factor
  • STAT-3 transcription-independent factor-3
  • the transfection cellular nucleus with OCT3/4, SOX2, NANOG was previously to be sufficient for inducing pluripotency in adult somatic cells (the creation of iPSC) and then lead to full pattern of embryonic stem cells theoretical characteristics: differentiation into 200 types of cells in the body, unlimited expansion, renewal potential, embryonic body formation, teratoma formation. Teratoma formation is a main threat of safety in cellular therapy.
  • absence expression of nanog in nucleus is an essential safety marker to determine whether a population of stem cell is suitable for systemic administration.
  • the lack of tumorigenicity of undifferentiated stem cells in vivo requires the absence of nanog in nucleus.
  • undifferentiated stem cells expressing inactive nanog, i.e. nanog localized in the cytoplasm also lack tumorigenicity in vivo.
  • Another important safety marker for a population of stem cells suitable for systemic administration is the expression of p53. This protein is crucial in multicellular organisms, where it regulates the cell cycle and thus prevents cancer by functioning as a tumor suppressor.
  • ABCG2 protein expression is also safety marker that indicates a population of stem cells is suitable for systemic administration.
  • ATP-binding cassette (ABC) ABCG2 protein (BCRP) expression is an important determinant of the MSC undifferentiated population phenotype.
  • ABCG2 might serve as a marker for undifferentiated stem cells from various sources, as its expression is sharply downregulated with differentiation.
  • AD Alzheimer's disease
  • ABCG2 transporters with Alzheimer's disease (AD) actively transport ⁇ as confirmed histopathologically in AD cases and controls.
  • Genome-wide association studies (Bertram L et al., 2007) have implicated a have identified genes the modulate AD risk, including genetic variants in ABCA7, a variant of ABC gene. It was concluded that increase in ABCA7 expression reduces AD risk, though increased ABCA7 expression during AD is insufficient to block disease progression (Jared B et al., 2014).
  • the pharmaceutical composition of the invention comprises stem cells from tissue of neural crest origin expressing at least one safety markers selected from the group consisting of ATP-binding cassette sub-family G member 2 (ABCG2), inactive nanog, p53, and SOX2.
  • the at least one safety marker is elected from the group consisting of ATP-binding cassette sub-family G member 2 (ABCG2), inactive nanog, and p53.
  • the IDPSC have high expression of ABCG2 and p53 but low expression of inactive nanog and SOX2.
  • the at least one safety marker is ABCG2 or p53, at least 75%, 80%, 85%, 90%, 95% or 98% of the stem cells of the pharmaceutical composition express the at least one safety marker.
  • the at least one safety marker is inactive nanog or SOX2, no more than 30%, 25%, 20%, 15%, 10%, 5%, or 5% of the stem cells express the at least one safety marker.
  • the stem cells of the pharmaceutical composition coexpress ABCG3, p53, inactive nanog, and SOX2, wherein at least 75% of the stem cells express ABCG2, at least 75% of the stem cells express p53, no more than 5% of the stem cells express inactive nanog, and no more than 30% of the stem cells express SOX2.
  • the pharmaceutical composition comprises stem cells from tissue of neural crest origin expressing at least one neuroepithelial stem cell marker selected from the group consisting of brain-derived neurotrophic factor (BDNF), neutrotrophin-3 (NT3), neutrotrophin-4 (NT4), neutrotrophin-5 (NT5), and p75.
  • the stem cells have high expression of the at least one neuroepithelial stem cell marker.
  • the stem cells of the pharmaceutical composition coexpress BDNF, NT3, NT4, NT5, and p75.
  • these embodiments pharmaceutical composition comprise stem cells from tissue of neural crest origin that are negative for HLA-DR.
  • the stem cells of the pharmaceutical composition may also be negative for certain MSC markers selected from the group consisting of c-Myc, KLf-4, and REX-1.
  • the stem cells of the pharmaceutical composition are negative for HLA-DR, c-Myc, KLf-4, and REX-1.
  • the pharmaceutical composition may comprise stem cells from tissue of neural crest origin expressing at least one safety markers selected ABCG2, inactive nanog, and p53 and further express at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • the pharmaceutical may comprise stem cells from tissue of neural crest origin expressing express at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75 while further expressing at least one safety markers selected ABCG2, inactive nanog, p53 and SOX2.
  • the present invention provides for methods for treating neurological diseases and conditions comprising systemically administering the pharmaceutical composition of the invention to a subject.
  • these methods of treating neurological diseases and condition promote neurogenesis and are protective in models of neurodegenerative diseases.
  • systemic administration the population of stem cells such as by IV administration, results in direct delivery of the cells to the brain.
  • neurogenesis occurs by the population of stem cells self-differentiating and/or activating intrinsic stem cells to migrate and differentiate.
  • neurogenesis is preferably dopamine-associated.
  • the neurological disease or condition is treated by the stem cells crossing the blood/brain barrier (BBB) and inducing neurogenesis.
  • BBB blood/brain barrier
  • the stem cells are directly transplanted into the brain parenchyma, including striatum, following crossing of the BBB.
  • the induced neurogenesis is dopamine-associated.
  • dopamine-associated neurogenesis occurs through self- differentiation of the stem cells or activation of migration and differentiation of intrinsic stem cells by the extrinsic stem cells.
  • massive dopamine-associated neurogenesis takes place in the subventricular zone (SVZ).
  • SVZ subventricular zone
  • the methods further comprise measuring the amount of DA receptor in the subject.
  • measuring the amount of DA receptor in the subject comprises imaging the subject to detect DA receptor.
  • neurogenesis is mediated by dopamine receptor D2, thus in some embodiments, the DA receptor measured is receptor D2.
  • the pharmaceutical composition provides neuroprotection.
  • systemic neuroprotection is provided with the high basal level of neurotrophic and immunoprotective factors expression and release pattern of the stem cells of the pharmaceutical composition.
  • these stem cells of the pharmaceutical composition are IDPSCs.
  • the neurological diseases and conditions include, for example, autism, schizophrenia, epilepsy, stroke and ischemia, a neurodegenerative disease or condition, a motor disorder, or a convulsive disorder.
  • the neurodegenerative disease or condition may be, for example, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), stroke, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, and Huntingdon's disease.
  • Motor disorders include, for example, Tourette syndrome, amyotrophic lateral sclerosis (ALS), progressive bulbar palsy, spinal muscular atrophy (SMA), post-polio syndrome (PPS).
  • Convulsive disorders include, for example, epilepsy.
  • the methods for treating neurological diseases and conditions support the natural neuro-protective mechanism in subjects diagnosed with early HD. In other implementations, the methods for treating neurological diseases and conditions repairs lost DA neurons in subjects diagnosed with PD.
  • the present invention also provides for methods of using the pharmaceutical composition as a preventive therapy for subjects at risk of HD.
  • the present invention is directed to a pharmaceutical composition for systemic administration to a subject to treat a neurological condition
  • a neurological condition comprising undifferentiated stem cells from tissue of neural crest origin expressing at least one safety markers selected from the group consisting of ATP-binding cassette sub-family G member 2 (ABCG2), inactive nanog, and p53.
  • ABCG2 ATP-binding cassette sub-family G member 2
  • inactive nanog is expressed nanog localizing predominantly in the cytoplasma of the undifferentiated stem cell.
  • at least 75% of the undifferentiated stem cells express the at least one marker when the at least one marker is ABCG2 or p53.
  • no more than 5% of the undifferentiated stem cells express the at least one marker when the at least one biomarker is nanog.
  • the undifferentiated stem cells express ABCG2, inactive nanog, and p53. In one aspect, at least 75% of the undifferentiated stem cells express ABCG2, at least 75% of the undifferentiated stem cells express p53, and no more than 5% of the undifferentiated stem cells express inactive nanog. In another aspect, the undifferentiated stem cells further express SOX2, and wherein no more than 30% of the undifferentiated stem cells express SOX2.
  • the undifferentiated stem cells further express at least one neuroepithelial stem cell marker selected from the group consisting of brain-derived neurotrophic factor (BDNF), neutrotrophin-3 (NT3), neutrotrophin-4 (NT4), neutrotrophin-5 (NT5), and p75.
  • BDNF brain-derived neurotrophic factor
  • NT3 neutrotrophin-3
  • NT4 neutrotrophin-4
  • NT5 neutrotrophin-5
  • p75 neuroepithelial stem cell marker selected from the group consisting of brain-derived neurotrophic factor (BDNF), neutrotrophin-3 (NT3), neutrotrophin-4 (NT4), neutrotrophin-5 (NT5), and p75.
  • the undifferentiated stem cells express BDNF, NT3, NT4, NT5, and p75.
  • the present invention is directed to a pharmaceutical composition for systemic administration to a subject to treat a neurological condition comprising undifferentiated stem cells from tissue of neural crest origin at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • the undifferentiated stem cells express BDNF, NT3, NT4, NT5, and p75. In other aspects, the undifferentiated stem cells further express at least one safety markers selected from the group consisting of ABCG2, inactive nanog, p53, and SOX2. In certain aspects, inactive nanog is expressed nanog localizing predominantly in the cytoplasma of the undifferentiated stem cell.
  • the undifferentiated stem cells express the at least one marker when the at least one marker is ABCG2 or p53.
  • the undifferentiated stem cells are negative for HLA-DR.
  • the tissue of neural crest origin is dental pulp.
  • the undifferentiated stem cells from tissue of neural crest origin are immature dental pulp stem cells (IDPSCs).
  • the present invention provides a method of treating a neurological disease or condition comprising systemically administering to a subject a pharmaceutical composition comprising undifferentiated stem cells from tissue of neural crest origin expressing at least one safety marker selected from the group consisting of ABCG2, inactive nestin, and p53.
  • the undifferentiated stem cells of the pharmaceutical composition further express at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • the present invention is directed to a method of treating a neurological disease or condition comprising systemically administering to a subject a pharmaceutical composition comprising undifferentiated stem cells from tissue of neural crest origin expressing at least one neuroepithelial stem cell marker selected from the group consisting of BDNF, NT3, NT4, NT5, and p75.
  • the undifferentiated stem cells of the pharmaceutical composition further express at least one safety marker selected from the group consisting of ABCG2, inactive nestin, p53, and SOX2.
  • the subject is intravenously administered the pharmaceutical composition.
  • the neurological disease or condition is treated by the population of undifferentiated stem cells crossing the blood/brain barrier and inducing neurogenesis.
  • the neurological disease or condition is treated by the undifferentiated stem cells inducing neurogenesis via dopamine-associated neurogenesis.
  • the dopamine-associated neurogenesis is through self-differentiation of the undifferentiated stem cells or activation of migration and differentiation of intrinsic stem cells by the undifferentiated stem cells.
  • the undifferentiated stem cells of the pharmaceutical composition provide neurotrophic factors and immunoprotective factors. In other embodiments, the undifferentiated stem cells of the pharmaceutical composition provides systemic neuroprotection. In one embodiment, the undifferentiated stem cells are autologous and/or allogeneic to the subject.
  • the neurological disease or condition is a neurodegenerative disease or condition.
  • the neurodegenerative disease or condition may be selected from the group consisting of Parkinson's disease (PD), multiple sclerosis, amyotrophic lateral sclerosis (ALS), stroke, autoimmune encephalomyelitis, diabetic neuropathy, glaucomatous neuropathy, Alzheimer's disease, and Huntington's disease (HD).
  • the method comprises systemically administering the pharmaceutical composition to the subject, wherein the subject is diagnosed with early HD, supports the natural neuroprotective mechanism in the subject. In other apsects, the method comprises systemically administering the pharmaceutical composition to the subject, wherein the subject is diagnosed with PD, repairs lost dopaminergic neurons in the subject.
  • the neurological disease or condition is selected from the group consisting of autism, schizophrenia, stroke, and ischemia. In other emobdiments, the neurological disease or condition is selected from the group consisting of a motor disorder and a convulsive disorder.
  • the subject is administered a single administration of the pharmaceutical composition. In one embodiment, the subject is administered a single intravenous injection of the pharmaceutical composition. In yet other embodiments, the subject is administered a first and a second administration of the pharmaceutical composition.
  • the subject is administered a first and a second intravenous injection of the pharmaceutical composition.
  • the second administration or intravenous injection of the pharmaceutical composition takes place at least 7 days after the first administration or intravenous injection.
  • the method further comprises measuring the amount of DA receptor in the subject. In another aspect, the method comprises measuring the amount of DA receptor in the subject comprises imaging the subject to detect DA receptor. In one aspect, the DA receptor is receptor D2.
  • IDPSCs demonstrate capacity to form colonies (FIG. 3).
  • the colony forming assay (CFU-F) assay was performed in triplicate at T20, P3 using 480 cells seeded in each plate, at day 8 multiple colonies colonies appeared and approximately 100 colonies were formed in each plate (FIG. 3).
  • Colony forming capacity is one of the principal characteristics of stem cell. Therefore, we conclude that this capacity was mantained when the cells were obtained using the disclosed multiharvest organ and tissue explant method. Additionally, the proliferative activity of LP IDPSC was evaluated as shown on FIG. 4, and these cells demonstrated a very high proliferative rate. Table 2. Comparison of the cell marker expression from the hIDPSC derived from the same donor by FACS analysis.
  • adenosine triphosphate binding cassette (ABC) transporters was also tested in the cells. ABC transporters are involved in the active transport of an extremely diverse range of substrates across biological membranes. These transporters are commonly implicated in the development of multidrug resistance and are also involved in numerous physiological and homeostatic processes, including lipid transport, cell migration and differentiation. Moreover there is evidence that ABC transporters serve as phenotypic markers and functional regulators of stem cells (Bunting 2002).
  • ABCBl protein the product of MDRl gene, but expression was higher in the late harvest.
  • hNSPCs human fetal neural stem/progenitor cells
  • BDNF brain-derived neurotrophic factor
  • the average level of BDNF secreted by 1 x 10 6 hIDPSCs is 6589 pg, which is many times higher than other types of MSCs that secrete BNDF, such as the MSCs of Gothelf et al. in 2014 (Clin Transl Med. 2014 3:21). Gothelf et al.
  • BM-MSC induced bone marrow-derived MSCs
  • BM-MSC-NTF neurotrophic factor-secreting cells
  • cAMP dibutyryl cyclic 15 AMP
  • hbFGF human Basic Fibroblast Growth Factor
  • PDGF-AA human platelet derived growth factor
  • hIDPSCs still secreted four times more BDNF than BM-MSC-NTF. Accordingly, the hIDSPCs have much greater neuroprotective potential than bone marrow-derived MSC induced to secrete neurotrophic factors.
  • MSCs generally express pluripotent markers such as Oct4, Nanog and Sox2 at low levels as described in the literature (Jiang et al., 2002; Guillot et al, 2007).
  • hIDPSC express very low levels of such markers in comparison with human embryonic stem cells and even induced pluripotent stem cells obtained from hIDPSCs (see FIG. 5).
  • hIDPSC express a high level of p53.
  • the tumor suppressor gene p53 is well known as a master regulator that helps keeps cancer at bay. Blocking the p53 pathway vastly improves the ease and efficiency of transforming differentiated cells into induced pluripotent stem cells (Dolgin, 2009). Derivation of neural and glial cells from the early and late harvests IDPSCs
  • the neuronal system consists of two classes of neural precursor cells: neuronal NPCs that differentiate into neurons and glial NPCs that differentiate into glia. Both neuronal and glial NPCs descend from the same neuroectodermal precursor.
  • a third class of neural precursor cells, neuroglioblast was also suggested. This third class of cells include radial glial cells also can act as neuronal precursors and only later, after neurogenesis, do they shift towards an exclusive generation of astrocytes.
  • the ability to distinguish whether a population of cells in cell therapy are neuronal NPSs or glial NPCs is of extreme importance for developing an efficient cell therapy strategy for treating neurodegenerative diseases, which mainly involve the damage or loss of both glia and neurons. It is possible to test known cell populations for the potential to differentiate into neurons or glia by inducing these cells to differentiate.
  • EP early population
  • LP late population
  • FIG. 6 The capacity of EP and LP IDPSC to produce neurons and glias was tested by inducing neuronal differentiation in EP and LP IDPSC at early (P2) and late passages (P7) according to the previously described protocol (Kerkis et al., 2006) (FIG. 6). After 7 days, the cells were collected and analyzed by flow cytometry using GFAP (glial fibrillary acidic protein) and beta-III-tubulin antibodies, respectively. A significant difference exists in the number of cells that express these markers between EP (B- E, left) and LP (B-E, right), which were established following a dental pulp (DP) harvesting protocol.
  • GFAP glial fibrillary acidic protein
  • IDPSCs can be neuronal and glial NPCs.
  • Early DP harvesting EP IDPSC
  • LP IDPSC late DP harvesting
  • SHED which are stem cells from human deciduous teeth, cannot be categorized as an early population or late population because they are stem cells isolated from dental pulp cells without DP harvesting.
  • the single SHED population contains neuron-committed and not glial-committed progenitors.
  • neuronal differentiation of SHED resulted in increased expression of beta-III-tubulin, GAD, and NeuN while the expression of nestin, GFAP, CNPase, and NFM remained the same after the induction of differentiation (see Figure 41 of Miura).
  • Example 2 Expression of CD146 and CD13 in Early Phase (EP) and Late Phase (LP) hIDPSC
  • CD 146 and CD 13 expression were analyzed by flow cytometry in EP -hIDPSC and LP-hlDPSC.
  • the results in FIG. 7 show that CD 13 was expressed in 52% of EP-hlDPSC and 95% of LP-hlDPSC.
  • MSCs from different sources can respond differently to different stimuli (Fraser JK et al., 2006).
  • Culture conditions e.g., media supplemented with either human serum or fetal calf serum (FCS), or serum-free
  • FCS fetal calf serum
  • SHED and IDPSCs have different methods of isolation and come from different stem cell niches. So it is unsurprising that SHED and IPSCs also have different expression of stem cell markers (see Table 4).
  • SHED To induce neuronal differentiation, SHED need EGF 20 ng/ml (BD Bioscience), FGF 40 ng/ml (BD Bioscience) and 3% rat serum. They need four weeks in neural inductive culture in order to show neural morphology and to increase expression of neuronal markers.
  • SHED neurotrophic factor
  • Cyclosporine A is shown to decreases the size of the ischemic brain infarct in rats and to protects against synaptic dysfunction and cell death in rodent models of traumatic brain infarct as well as to protects striatal neurons from mitochondrial dysfunction in Huntington disease (Matsomoto et al., 1999; Albensi et al. 2000; Leventhal et al., 2003). Therefore, benefits observed in Parkinsonian rats and HI, cannot be purely attributed to SHED but also to Cyclosporine A intervention.
  • hIDPSCs from Avita International LTD as advantageous over other therapeutic stem cells on the market or in clinical trial.
  • Avita International LTD's hIDPSCs have a good safety profile with low risk of immunogenicity and has low cost of production, as they can be cryopreserved.
  • Example 5 Certificate of Analysis of IDPSCs (Cellavita) used for sterile IV injection Certificate of analysis (Table 6) of a representative batch of IDPSCs used for IV injection into animal models confirm the characterization results of IDPSCs. Table 6
  • Example 6 Identification of the parameters for safe systemic administration of a stem cell treatment
  • IDPSC shows Oct4 nuclear localization (FIG. 8A-B). While a majority of IDPSCs have Nanog in the cytoplasm of cells (FIG. 8C-D), very rare cells demonstrate nuclear localization as well. The intracellular localization of Sox2 in IDPSCs is mainly nuclear (FIG. 8E-G), though several cells can show cytoplasmic localization too. Interestingly, we can observe the symmetrical division (FIG. 8D-F) when Nanog and Sox2 expression in observed in both daughter cells, and observe asymmetric division when after division the daughter cells do not express these markers or loses the characteristic of stem cells and becomes a less potent progenitor or a differentiated cell (FIG. 8E-F).
  • teratoma assay sensitivity and quantitativity; definitive cell number and single cell suspension production; immunophenotyping of studied cell in respect of expression on pluripotent cell markers and karyotype; co-transplantation of studied cells together with Matrigel.
  • the cells were transplanted subcutaneously (s.c) into NOD/SCID mice, which allows for simple monitoring of teratoma development.
  • iPS-IDPSC immature dental pulp stem cells
  • Disclosed multiharvest explant like culture used for the isolation of a population of immature dental pulp stem cells results in expression of embryonic stem cell markers Oct-4, Nanog, SSEA-3, SSEA-4, TRA-1-60 and TRA-1-81 as well as several mesenchymal stem cell markers during at least 15 passages while maintaining the normal karyotype and the rate of expansion characteristic of stem cells.
  • the expression of these markers was maintained in subclones obtained from these cells.
  • in vitro these cells can be induced to undergo uniform differentiation into smooth and skeletal muscles, neurons, cartilage, and bone under chemically defined culture conditions.
  • IDPSC although have a small size and cytoplasm poor in cell organelles differ from naive pluripotent cells presenting typical mesenchymal - fibroblast like morphology. Therefore IDPSC are of mesenchymal type, in contrast to ES and iPS cells, which are of epithelial type (FIG. 8).
  • ES and iPS cells which are of epithelial type (FIG. 8).
  • this method was validated using dog fetal stem cells from bone marrow, liver, yolk sac, allantois and amniotic liquid which also express pluripotent markers.
  • Example 7 Identification of parameters for effective systemic administration of a stem cell treatment
  • Culture conditions can affect gene expression of the cells.
  • genes include ABCG2 and Vimentin, which are two genes that can indicate suitability of the cells in culture for therapeutic use, particularly systemic cellular systems like the present invention.
  • Most suitable culture medium form tested is DMEM/F12 basal medium supplemented with 5-10-15% of FBS, antibiotics, and Glutamate, and the cells should be cultured without an adhesion layer (e.g. without extracellular matrix (ECM) or scaffold) such that the cells adhere directly to the culture dish or beads plastic.
  • ECM extracellular matrix
  • Cells that were grown with epithelial growth media conditions turn into epithelial-like cells.
  • ECM coating can be useful for scale up of current cells into 3D culture conditions including bioreactors, such as Terumo hollofiber bioreactor, Eppendorf- New Brunswick bioreactors with beads, etc.
  • bioreactors such as Terumo hollofiber bioreactor, Eppendorf- New Brunswick bioreactors with beads, etc.
  • the link of ABCG2 expression and undifferentiation status of cells is shown in FIGs. 10 and 11, where demonstrated that once ABCG2 not expressed due to changed culture medium or coating layer, then - cells have clear more fibroblast or epithelial cells-like morphology.
  • DMEM Dulbeccos Modified Eagle Medium
  • KSFM serum knockout medium
  • Dulbeccos Modified Eagle Medium DMEM
  • DMEM Dulbeccos Modified Eagle Medium
  • NB Neurobasal medium
  • Exemplary protocols for differentiation into cells of the neural lineages have also been described in previous patent applications, for example, International Application no. PCT/IB 14/59850 and U.S. Patent Application No. 14/2140,016.
  • AM Amniotic membrane
  • DMEM Dulbecco's- modified Eagle's medium
  • the culture medium was changed daily, and the cells were replaced every 3 days. After they reached 80% confluence, they were washed twice in sterile phosphate-buffered saline (PBS; Gibco; 0.01 M, pH 7.4), enzymatically treated with 0.25% trypsin/EDTA (Invitrogen), and seeded onto amniotic membrane previously prepared.
  • PBS sterile phosphate-buffered saline
  • trypsin/EDTA Invitrogen
  • SHEM hormonal epithelial medium
  • DMEM/F12 Dulbecco's Modified Eagle's Medium/Ham's F-12 nutrient mixture
  • Invitrogen Gibco Cell Culture, Port- land, OR; 1 : 1 containing 1.05 mM calcium supplemented with 5 ⁇ g/ml crystalline bovine insulin
  • the second was keratinocyte serum-free medium (KSFM) containing 0.09 mM calcium supplemented with 30 mg/ml pituitary bovine extract, 0.2 ng/ ml EGF, 10% FBS, and ampicillin/streptomycin.
  • KSFM keratinocyte serum-free medium
  • Knockout media containing 0.06 mM calcium supplemented with 1% "human corneal growth supplement” (Cascade Biologies), containing 0.2% pituitary bovine extract, 5 g/ml bovine insulin, 0.18 mg/ml hydrocortisone, 5 ⁇ g/ml bovine transferrin, 0.2 ng/ml EGF, added
  • Mouse anti -human monoclonal antibodies ABCG2 (Chemicon) and cytoplasmic/nuclear monoclonal antibodies: mouse anti-cytokeratin 3/12 (K3/ 12) (RDI, Flanders, NJ, USA), reacts with human and rabbit.
  • Mouse anti-human IDPSC antibody was obtained as described (Kerkis et al., 2006) and successfully used by us in previous studies (Fonseca et al., 2009; Monteiro et al, 2009).
  • Microscope slides were mounted in antifade solution (Vectashield mounting medium, Vector Laboratories, Hercules, CA, USA) with 4',6-diamidino-2-phenylindole (DAPI) and analysed using a confocal microscope. Control reactions were incubated with PBS instead of primary antibody, followed by washing and incubation with respective secondary antibody. All experiments have been done in triplicate.
  • antifade solution Vectashield mounting medium, Vector Laboratories, Hercules, CA, USA
  • DAPI 4',6-diamidino-2-phenylindole
  • FIG. 12 depicts that IDPSC had differential response in respect of expression of studied proteins when cultured in distinct culture medium during 7 days.
  • the IDPSCs grown on plastic surfaces did not express ABCG2 when cultured in SHEM, KSFM, Epilife and DMEM/KO (FIG. 10 A1-A4), this protein was expressed in IDPSCs only when they were cultured in basal culture medium (FIG. 10 A5).
  • IDPSCs cultured in SHEM and DMEM/KO after seven days changed their morphology fibroblast like (FIG. 10 A5) to epithelial like (FIG. 10 B2 and B4) and start to express CK3/12, while IDPSC cultured in Epilife and KSFM and DMEM/F 12 did not start to express K3/12 (FIG. 10 B1, B3, B5).
  • IDPSC grown on AM during 7 days (FIG. 11). Epilife was excluded from this study due to very low survival of the cells (less then 50%), when grown in this medium and low adherence of the cells on AM in combination with Epilife. Vimentin expression was observed in all samples (FIG. 11 A-A3), it was positive in IDPSCs cultured in DMEM/F 12 and SHEM (FIG. 11 A and A2) and showed weak positivity with IDPSCs cultured in KSFM and DMEM/KO (FIG. 11 A2 and A3). ABCG2 antibody showed strong immunopositivity with IDPSC cultured in SHEM and DMEM/F12 (FIG. 11 B and Bl) and did not express in IDPSC cultured in KSFM (FIG.
  • IDPSCs did not react with IDPSCs cultured in DMEM/F12 e KSFM (FIG. 11 C and C4) and showed very weak immunopositivity with K3/12 when cultured in SHEM and DMEM/KO (FIG. 11 CI and C3).
  • FIG. 12 summarizes the preclinical pharmacology studies, which aimed at examining the different clinical applications of the investigational product CELLAVITATM (stem cells). Although many of the studies were conducted to investigate the pharmacological efficacy of the cells for various indications, they are all demonstrate the safety profile of the product as well as of the proposed intravenous administration.
  • Table 7 depicts CELLAVITATM (stem cells) specifications.
  • Cell doublings Cell doublings number At least doubling of cell number in
  • Endotoxins Less than or equal to 1.0 EU/mg ⁇ 0.005 EU/mg A280 protein
  • Mycoplasma tests are performed regularly during cultivation of hIDPSC with an in- house RT-PCR test (EZ-PCR Biological Industries, Israel) according to the manufacturer's protocol.
  • NGF-PE R&D systems, MN, USA. 2x105 cells were used for the FACS experiments.
  • BDNF levels were quantified by using a human BDNF Quantikine ELISA kit, according to the manufacturer's protocol (R&D Systems, MN, USA).
  • Table 8 depicts batch Number 001H1-30/P1-5/F analysis.
  • Avita performed non GMP, non GLP studies regarding hIDPSC stability.
  • a single master cell bank which may mitigate variability of the final batch, was established. It was composed by 5 batches, each derived from Dental Pulp of one individual. The cells were produced as described in FIG. 13. The time line of stability studies of hIDPSC is presented on FIG. 14.
  • CELLAVITATM stem cells
  • MSC mesenchymal stem cells
  • Huntington's disease is an inherited disease of the brain that damages certain brain cells.
  • the disease damages some of the nerve cells in the brain, causing deterioration and gradual loss of function of these areas of the brain. This can affect movement, cognition (perception, awareness, thinking, judgment) and behavior.
  • chorea There are typical involuntary movements called chorea, manifested by muscle, spontaneous and transient contractions. This symptom is present in over 90% of patients with this disease.
  • the patient's voluntary movements become slower and they showed severe difficulties in equilibrium. Often the difficulty in words articulating (dysarthria) and in food swallowing (dysphagia) is noted.
  • the patient may also present muscle rigidity, dementia and psychiatric disorders such as depression and delusions.
  • HD is characterized by a progressive loss of medium spiny neurons, predominantly the GABAergic neurons, in the basal ganglia. Moreover, HD is associated with severe striatal Dl and D2 receptor loss and taking in consideration that recently it was reported that disregulation of dopamine receptor D2 as a sensitive measure for Huntington disease pathology in model mice (Crook et al., 2012; Chen et al., 2013). HD becomes most prominent in the neostriatum, commonly referred to as the striatum, which also includes the caudate nucleus and putamen.
  • BDNF brain-derived neurotrophic factor
  • 3-NP is an irreversible inhibitor of succinate dehydrogenase that inhibits both the Krebs cycle and Complex II and systemic administration of 3-NP to both rats and primates can produce selective striatal lesions that are a consequence of secondary excitotoxic mechanisms [95-96] . These lesions accurately replicate a number of motor and neuropathological symptoms observed in HD patients.
  • Systemic administration of 3-NP results in differential sparing of striatal NADPH-diaphorase and large cholinergic neurons with a significant loss of striatal GABAergic neurons activity of the electron transport chain.
  • HD was induced with daily intraperitoneal injection of 20 mg/kg of 3-NP (Sigma- Aldrich) for 4 days.
  • the human IDPSC were isolated according to the protocol already established for Kerkis and colleagues (2006). The cells were expanded to passage 4. The cells were immunopositive for MSCs markers such as CD 105, CD90, and CD73; pericyte markers such as CD146; and neural crest stem cells marker such as CD271. The cells were negative for CD45 (blood cells marker) and HLA II (major histocompatibility complex: human leukocyte antigen class II molecules). All procedures were developed in the presence and under supervision of veterinarian specialized in neural system diseases.
  • IDPSC insulin-dysine-phosphate-semiconductor
  • Vybrant green-dye Invitrogen, Carlsbad, CA, USA
  • V12883 green-dye Invitrogen, Carlsbad, CA, USA
  • a total of 1x106 IDPSC were transplanted intravenously (caudal vein), and after 4 days (pilot study) or after 35 days (Group I study), the animals were euthanized.
  • the brain were collected for histological and immunohistochemical analysis (FIGs. 15 and 16).
  • FIG. 18 demonstrates hIDPSC engraftment throughout the striatum and cortex parenchymal tissue. Tissues were evaluated by immunohistochemistry using the specific anti- human cells nuclei antibody (brown) and the anti-hlDPSC antibody (green). hIDPSC was co- localized with CD73 (red), a marker for human MSC producing as a result yellow color.
  • mice After the induction of HD with 3-NP acid, the mice showed similar functional and anatomical characteristics with human's symptoms of HD:
  • hIDPSC showed double positive immunostaining for anti-IDPSC antibody CD73 and CD 105 demonstrating that 4 days after transplantation most of the cells were still undifferentiated.
  • hIDPSC were mainly localized in the parenchyma of the striatum and close to capillaries (FIG. 20).
  • IDPSC transplanted via IV in HD rats induced by 3-NP were able to cross BBB and to migrate into lesioned area. These cells demonstrated significant engraft in parenchyma and around capillaries. Four days after transplantation, the cells are still undifferentiated; however a few human cells that present neuron-like morphology were also observed. Results: Group I study
  • the aim of the study was to identify the IDPSC in rat's brain 30 days after IV injection. Thirty days after IDPSC injection they were observed in cortex and mainly in striatum close to capillaries, typical localization of brain pericytes (FIG. 21). Additional serial cut obtained from rat's brain demonstrates neuron like morphology of IDPSC localized in parenchyma (FIG. 22). Unexpectedly the IDPSC were found in Subventricular zone (SVZ), which is considered stem cell niche of neurons in adult brain (FIG. 23). Other surprising unexpected result that was obtained is a robust production of DARPP32 positive neurons in rats, which received hIDPSC transplantation. In contrast this was not observed in control groups (FIG. 24).
  • SVZ Subventricular zone
  • DARPP-32 Dopamine- and cAMP-regulated phosphoprotein, Mr 32 kDa (DARPP-32), was identified initially as a major target for dopamine and protein kinase A (PKA) in striatum.
  • PKA protein kinase A
  • the regulation of the state of DARPP-32 phosphorylation provides a mechanism for integrating information arriving at dopaminoceptive neurons, in multiple brain regions, via a variety of neurotransmitters, neuromodulators, neuropeptides, and steroid hormones (Svenningsson et al, 2004).
  • HD is associated with severe striatal Dl and D2 receptor loss and taking in consideration that recently it was reported that dysregulation of dopamine receptor D2 as a sensitive measure for Huntington disease pathology in model mice (Crook et al., 2012; Chen et al., 2013), therefore we used this marker to evaluate possible effect of IDPSC in 3-NP induced rats.
  • this marker Surprisingly, we observed significant difference in receptor D2 expression in rats, which received IDPSC in comparison with untreated groups, a few of expression of receptor D2 cells can be observed in the striatum of control animals. Therefore we suggested three score system for this protein expression (FIG. 25), which can be quantified also.
  • FIG. 26 presents an example scoring system for evaluating motor deterioration.
  • Clinical evaluation of all studied animals after induction of HD is presented in Table 9.
  • FIGs. 28-31 shows the weight chances of animals in the pilot study, Group II study, and Group III study. In the longer term studies, animals treated with IDPSCs had higher body weight than untreated animals.
  • the research group tested the neuroprotective and/or neural tissue remodeling effects of hIDPSC in a 3-NP chemical model of Huntington's disease.
  • 3-NP mitochondrial toxin 3-nitropropionic acid
  • SDH mitochondrial succinate dehydrogenase
  • 3-NP can be administered systemically, causing selective neurodegeneration of the striatum or the entire corpus striatum.
  • 3-NP administration can simulate different stages of Huntington's disease.
  • Intraperitoneal injections of two 3-NP doses lead to hyperkinetic symptoms in mice in the early stages of disease, whereas four or more doses result in hypoactivity in the late stages of disease (Beal et al., 1993; Brouillet et al, 1995; Yang et al., 2008; Borlogan et al., 1997).
  • 3-NP-treated animals has an important limitation if compared to transgenics.
  • 3-NP model the striatum lesion can regenerate spontaneously, after 10-12 days because of the presence of normal intrinsic neuronal precursors and an absence of genetic background which provides constant neurodegeneration. Therefore, difference in motor and functional improvements between experimental and control groups can be observed before spontaneous neuroregeneration.
  • mice treated with 3NP+ hIDPSC performed better compared to rats treated with 3NP.
  • 5-days after hIDPSC transplantation the rats exhibited better improvement after HDPSC transplantation.
  • rats presented score 1, 3 score 2 and 2 score 3 and no rats presented score 4 after HIDPSC transplantation (Table 12).
  • control group (3NP+saline solution) 38 rats presented score 1, 1 score 2 and 5 score 3 and 1 rat presented score 4 (Table 11).
  • Table 13 depicts neurological score of control group (3NP+ saline solution) and hIDPSC group (3NP+ hIDPSC transplant) after 3NP treatment (4 days of administration), 1 day and 5 days after 3NP induction and after HIDPSC transplantation.
  • Normal behavior with no gait abnormalities (score 0); general slowness (score 1); incoordination and gait alterations (score 2); inability to move either the hind limbs or forelimbs (score 3); and inability to leave the lying position. This last group eventually died (score 4).
  • Histopathological and immunohistological analyses were conducted 7, 30, and 90 days after hIDPSC injection; animals were perfused with 4% paraformaldehyde (prepared in PBS, 0.1 mol/L). Tissue fragments were dehydrated in a decreasing ethanol series (75, 95, and 100%) and stained using Nissl staining with 0.1% cresyl violet. Two antibodies, such as, anti-human nuclei and anti-hlDPSC (1 : 1000, Abeam Pic) were used to determine the presence of hIDPSC in rat brain.
  • hIDPSCs were detected in the cortex and corpus striatum, indicating that they were able to cross the blood-brain barrier and migrate to the site of injury (FIG. 33).
  • optical cuts demonstrate at different depth of focus (A1-A4) the presence of IDPSC stained with Vybrant (green), and nuclei are stained with PI (red).
  • the cells demonstrate capillary predominant association and different morphological types: neuron-like cells and pericytes. On A2, A3, and A4 two pericytes at different locations along capillary can be observed, and both present similar morphology. On A4 embranchment of axons is shown.
  • hIDPSC-derived neuron-like cells and pericytes were also observed in the same period (FIG. 33).
  • FIG. 34 the optical cut demonstrates IDPSC stained with Vybrant (green) and positively reacted with anti -IDPSC antibody (red). Superposition of both produce yellow color.
  • the cell demonstrate near capillary localization.
  • Two markers for MSC were used: CD73 and CD 105 demonstrating positive reaction with IDPSC.
  • a confocal microscope with epifluorescence + Digital Interference contrast (DIC) was used.
  • 3-NP-induced striatal lesions were determined by neuron loss using Nissl staining and
  • DARPP32 expression (FIG. 37 and FIG. 38, respectively). Nissl stains are used to identify neuron structures in the brain and spinal cord (FIG. 37), whereas DARPP32 is a cytoskeleton marker expressed in GABAergic neurons and prevalent in the striatum of healthy mammals (FIG. 38). Using these two markers, neuron loss in the corpus striatum was scored as follows:
  • Score 1 severe neuron loss, with areas of degradation, loss of DARPP32 immunostaining in the lateral striatum with little or no cells in the central striatum;
  • Score 2 moderate neuron loss with "dark neurons” (dead or apoptotic neurons) and few DARPP32+ cells;
  • 3-NP-treated animals showed complete or partial neuron loss in the striatum compared to controls (no 3-NP or hIDPSC).
  • the two experimental groups presented different scores for neuronal loss in the striatum relative to controls.
  • morphometric histological analysis revealed that most hIDPSC-treated animals had scores 3 and 2, whereas most untreated animals (3-NP + saline solution) had neuron loss scores of 2 and 1 (FIG. 38). No animal had visible atrophy (FIG. 37 and FIG. 38).
  • FIG. 39 depicts neuronal growth in the striatum of rats after hIDPSC.
  • Administration of hIDPSC resulted in a neuroreparative effect in hIDPSC-treated animals by (A) Nissl staining and (B) DARPP32 expression.
  • C Number of animals showing neuron recovery after hIDPSC administration compared to Controls. Most hIDPSC-treated animals (3-NP + hIDPSC) had scores 3 and 2 (moderate and mild) whereas most untreated animals (3 NP + saline) had scores 2 and 1 (severe and moderate).
  • DARPP32 dopamine- and cAMP-regulated neuronal phosphoprotein (DARPP-32), was identified initially as a major target for dopamine and protein kinase A (PKA) in striatum.
  • PKA protein kinase A
  • the regulation of the state of DARPP-32 phosphorylation provides a mechanism for integrating information arriving at dopaminoceptive neurons, in multiple brain regions, via a variety of neurotransmitters, neuromodulators, neuropeptides, and steroid hormones (Svenningsson et al., 2004).
  • HD is associated with severe striatal Dl and D2 receptor loss and taking in consideration that recently it was reported that dysregulation of dopamine receptor D2 as a sensitive measure for Huntington disease pathology in model mice (Crook et al., 2012; Chen et al., 2013), therefore we used this marker to evaluate possible effect of IDPSC in 3-NP induced rats.
  • BDNF's mRNA and protein levels have been observed in the cerebellum, caudate putamen, striatum, and cerebral cortex of HD patients (Adachi et al., 2014).
  • BDNF expression was observed in the striatum, caudate, putamen, and subventricular zone of hIDPSC-treated animals 7 and 30 days after hIDPSC administration (FIG. 40).
  • BDNF expression in the subventricular zone indicates that hIDPSC promoted neurogenesis. No BDNF expression was observed in untreated animals (3-NP + saline).
  • hIDPSCs Histological and immunohistochemical analyses revealed that hIDPSCs were able to cross the blood-brain barrier and reach different areas affected by HD, including the striatum and cortex. Morphometric histological analysis revealed that most hIDPSC-treated animals showed mild neuron loss in the striatum compared to untreated animals (3-NP + saline). Moreover, hIDPSCs showed neuroprotective and neuroreparative effects, as revealed by the upregulation of BDNF, DARPP32, and D2 receptor expression, which are downregulated in Huntington's disease (Van Dellen et al, 2000; Crook and Housman, 2012).
  • the primary study assessing safety of hIDPSC was the 3-nitropropionic acid (3-NP) rat model of HD study.
  • 3-NP-treated rats received a single IV injection or a total of three IV injections at one month intervals of the cells.
  • HD is a clinically debilitating disease for which there is no available therapy to stop or reverse disease progression.
  • BBB blood- brain barrier
  • the BBB is a highly selective permeability barrier that separates the circulating blood from the extracellular fluid surrounding the nervous system. Treatment with cell-based therapeutics, therefore, would seem to require localized delivery bypassing the BBB (i.e. injection through the selective permeability barrier) since cells do not generally cross the BBB.
  • hIDPSCs have mesenchymal stem cell (MSC) attributes, can secrete immunomodulating and neurotropic factors.
  • MSC mesenchymal stem cell
  • histological and immunohistochemical analyses in validated HD rat model reveal that hIDPSCs are able to cross the BBB and reach different areas affected by HD, including the striatum and cortex.
  • hIDPSC-treated animals show mild neuron loss in the striatum compared to untreated animals.
  • hIDPSCs show neuroprotective and neuroreparative effects by upregulating BDNF, DARPP32, and D2 receptor expression, which are downregulated in Huntington's disease (Van Dellen et al.,
  • hIDPSCs are safe and efficacious in the treatment of HD. Since the studies suggest hIDPSCs are safe and efficacious in the treatment of HD, we propose to use hIDPSCs to treat HD.
  • Example 12 Neuroprotection effect of hIDPSC on brain. Short and long-term effect of hIDPSC on BDNF expression in rat HD model (induced by 3-NP) after their systemic administration (intravenous route). Introduction
  • Neurotrophic factors such as brain-derived neurotrophic factor (BDNF) are essential contributors of central nervous system neuron function.
  • BDNF plays an important role in neuronal survival and growth, serves as a neurotransmitter modulator, and participates in neuronal plasticity, which is essential for learning and memory.
  • BDNF is also that support differentiation, maturation, and survival of neurons in the nervous system and shows a neuroprotective effect.
  • BDNF stimulates and controls growth of new neurons from neural stem cells (NSC).
  • NSC neural stem cells
  • Huntington's disease decreased levels of BDNF are associated with neuronal loss. Studies demonstrate their reduced availability in diseased brains, thus suggesting that they play an important role in neurological disorders and, in particular, in HD.
  • BDNF is synthesized in the cortex, the substantia nigra pars compacta, the amygdala, and in the thalamus. All these regions supply the striatum with BDNF.
  • the deficit of BDNF in the striatum may be due to reduced BDNF gene transcription in the cerebral cortex or reduced BDNF vesicle transport (or both).
  • the decrease in BDNF expression observed in HD impairs dopaminergic neuronal function, which may be associated with HD motor disturbances.
  • many studies have been carried out to examine whether increasing BDNF levels may help treat HD (1"7) .
  • BDNF Immunohistochemistry Expression of BDNF was analyzed using anti-human anti-BDNF (Santa Cruz) antibody and immunohistochemistry assay.
  • HD animals induced with 3-NP and treated with hIDPSC or with placebo were sacrificed 4 and 30 days after the cells transplantation, brain were isolated and respective brain compartments were dissected, fixed in 4% paraformaldehyde in PBS and included in paraffin. Paraffin slides were deparaffinized using the routine technique. Then, the slides were incubated with ammonia hydroxide ( Sigma- Aldrich) for 10 min and washed four times in distilled water for five min each.
  • ammonia hydroxide Sigma- Aldrich
  • Antigen retrieval of the slides was performed using a pH 6.0 buffer of sodium citrate (Sigma-Aldrich), in a water bath set at 95°C for 35 min.
  • the slides were blocked with hydrogen peroxide (Sigma-Aldrich) for 15 min and incubated overnight at 4°C with polyclonal anti-human BDNF Antibody (N-20) in rabbit, diluted 1:500 in BSA (Sigma- Aldrich).
  • the slides were rinsed three times with PBS for five min each and Anti- Rabbit AP (SC-2057)diluted 1: 100 in PBS (both anti-bodies from Santa Cruz Biotechnologies, Dallas, Texas, U.S.A) were added for 40 min at room temperature.
  • Short term effect of hIDPSC transplantation Expression of BDNF just after HD induction by 3-NP in rats and 4 days after hIDPSC transplantation.
  • FIG. 43 demonstrates innumerous BDNF positive cells (here and further brown color) in rat cortex (FIG. 43 la and lb) and in striatum (FIG. 43 le and If), known as a NSC niche. A few of these cells is observed in hippocampus (FIG. 43 lc and Id). However, these cells showed morphology similar with neuronal progenitor and not mature neurons. 3-NP treated animals which received saline solution (PBS) did not show any BDNF secreting cells (FIG. 43 2a to 2f). Long term effect of hIDPSC transplantation: Expression of BDNF just after HD induction by 3-NP in rats and 30 days after hIDPSC transplantation.
  • PBS saline solution
  • FIG. 44 demonstrates innumerous morphologically mature neurons in the cortex that secret BDNF (FIG. 44 la and lb). In hippocampus BDNF secreting cells are also present (FIG. 44 lc and Id) and many of BDNF expressing cells were observed in striatum (FIG. 44 le and If). In control group BDNF secreting was not still observed (FIG. 44 2a to 2f).
  • Example 13 Veterinary treatment of multiple sclerosis-like Canine distemper virus (CDV) disease in dogs
  • CDV in dogs is a well-defined virus-induced demyelination model with an etiology similar to etiology of multiple sclerosis.
  • Functional recovery shown in the example disclosed herein suggests that IDPSC induce gliogenesis under CDV pathophysiological conditions that is correlated with our previous disclosure of expression of p75 neurotrophin receptor, a marker for Schwann cells, in hIDPSCs cultured by Cellavita method; or/and induce immunoprotection mechanism to provide functional recovery.
  • p75 neurotrophin receptor a marker for Schwann cells
  • hIDPSCs a marker for Schwann cells
  • Table 15 below briefly shows that most of patients have symptoms recovery; only one patient had no effect at all. Most of the patients had symptoms of recovery after second transplantation while some patients had demonstration of trends to recovery already after first transplantation. Over 90% demonstrated partial recovery after 3 rd transplantation. About 50% demonstrated full recovery after third transplantation.
  • Quadriplegia Inability to stand and Inability to stand and Inability to stand and bear weight severe bear weight moderate bear weight moderate ataxia and paresis in ataxia and paresis in ataxia and paresis in both limbs both limbs both limbs
  • Example 14 Batch Release Process for Industrial Scale-Up of Multiharvest Organ and Tissue Explant Culture Of hIDPSC - CELLAVITATM (Stem Cells) Product by Late Population Method
  • CELLAVITATM stem cells
  • CELLAVITATM (stem cells) is referred to as Drug Substance (DS).
  • CELLAVITATM (stem cells) for IV infusion is referred to as Drug Product (DP).
  • the Process for the CELLAVITATM (stem cells) Substance initiates at donor screening and testing and finishes prior to final formulation and cryopreservation of the cell stock.
  • Preparation of the Drug Product involves formulation of the CELLAVITA 1 (stem cells) substance with additional excipients.
  • CELLAVITATM stem cells
  • stem cells are stem cells expressing neural crest/mesenchymal stem/ progenitor cell markers, such as CD13, CD105 (Endoglin), CD73, CD29 (integrin b-1), CD44, and nestin (Kerkis et al., 2009; Kerkis et al., 2006) obtained using multiharvest organ and tissue explant culture.
  • CELLAVITATM stem cells
  • the cells are defined in accordance with minimal criteria for defining multipotent mesenchymal stromal cells established by the Mesenchymal and Tissue Stem Cell Committee of the International Society for Cellular Therapy. This definition includes being plastic-adherent when maintained in standard culture conditions, expressing CD105, CD73 and CD90, and lack expression of CD45, CD34, CD14 or CD1 lb, CD79alpha or CD 19 and HLA-DR surface molecules, and ability to differentiate to osteoblasts, adipocytes and chondroblasts in vitro (Dominici et al., 2006).
  • the tooth Immediately after spontaneous exfoliation, the tooth are immersed into 3 mL of sterile transporting solution composed of DMEM (Dulbecco ' s Modified Eagle Medium) and 500 mM Gentamycin in a 15 mL sterile centrifuge tube.
  • DMEM Dulbecco ' s Modified Eagle Medium
  • 500 mM Gentamycin 500 mM Gentamycin in a 15 mL sterile centrifuge tube.
  • the tooth are stored at 4oC and processed within 48-72 hours.
  • a freshly exfoliated deciduous tooth from a healthy subject is washed repeatedly in sterile solution containing 50% pen/strep solution (100 units/mL penicillin, 100 units/ mL streptomycin) and 50% Phosphate Buffered Saline (PBS). Dental pulp is removed from the tooth with the aid of a sterile needle.
  • pen/strep solution 100 units/mL penicillin, 100 units/ mL streptomycin
  • PBS Phosphate Buffered Saline
  • DP freshly obtained dental pulp
  • Pen/strep solution 100 units/mL penicillin, 100 units/ mL streptomycin.
  • Initial plating and viability testing of the dental pulp is performed in dental pulp Maintenance Medium supplemented with 15% fetal bovine serum (FBS, Hyclone), 100 units/mL penicillin, 100 units/ mL streptomycin, 2 mM L-glutamine, and 2 mM nonessential amino acids. This procedure usually takes up to one week.
  • FBS fetal bovine serum
  • the production process comprises the steps illustrated in FIG. 48 which demonstrates the initial process of CELLAVITATM (stem cells) isolation and batch formulation.
  • the vertical pathway shows the process of dental pulp mechanical transfer (harvest) of early population-hlDPSC (isolated from dental pulp before 5 harvests) and late population - hIDPSC (isolated from dental pulp after 5 harvests).
  • the horizontal pathway shows the traditional enzymatic method of cell cultures when cells are replaced through repetitive passages.
  • the final batch product is a sum of hIDPSC obtained from dental pulp harvests and passages (no more then 5).
  • the production process comprises the steps illustrated in FIG. 48 and/or FIG. 49.
  • the production process includes CELLAVITATM (stem cells) isolation and batch formation.
  • the vertical pathway shows the process of dental pulp (DP) mechanical transfer (harvest) for early population-hlDPSC isolated from dental pulp before 5 harvests and late population - hIDPSC isolated from DP after 5 DP harvests; the horizontal pathway shows traditional enzymatic method of cells culturing, when cells are replaced through repetitive passages.
  • Final batch - product is a sum of hIDPSC obtained from DP harvest and passages (no more then 5).
  • the production of CELLAVITA (stem cells) is performed in a state of the art clean room facility according to GMP regulations. In one embodiment, this production process follows the steps outlined in FIG. 50. hIDPSC Harvesting
  • hIDPSC is washed with sterile PBS, removed with TrypLE solution and centrifuged. The pellet is resuspended in DP Maintenance Medium and thereafter is seeded in the tissue culture flask (Passage 1-Pl). When the cells reach about 80% confluency they are passed to the new flask (Passage 2-P2). Cells arew incubated in a humidified 5% CO 2 incubator.
  • hIDPSC from P5 are maintained in culture for at least 3-5 days in order to collect cell conditioned medium for sterility and mycoplasma testing.
  • Sterility test are performed by ISO, GMP certified methodologies.
  • ⁇ Mycoplasma testing is performed using an in-house RT-PCR test (EZ-PCR Biological Industries) and by ISO, GMP certified.
  • the hIDPSC freezing protocol is adapted to the standard freezing repository protocol- hIDPSC from P5 is transferred into 2 mL cryopreservation vials containing 1 mL of freezing media, composed of: 90% FBS and 10% DMSO (GMP/US pharmaceutical grade). 1x106 cells per vial are cryopreserved.
  • Cryopreservation vials are placed inside a Nalgene Cryo loC Freezing Container filled with isopropyl alcohol and are placed at -80°C overnight. Thereafter, vials aretransferred to the vapor phase of a liquid nitrogen storage tank and their locations recorded. Control of Materials
  • Table 17 depicts the process, which used for the control of materials.
  • teratomas is an essential tool in determining the pluripotency of any pluripotent cells, such as embryonic or induced pluripotent stem cells (ES and iPS cells).
  • ES and iPS cells embryonic or induced pluripotent stem cells
  • the method described herein aisbased on the subcutaneous co-transplantation of defined numbers of undifferentiated mouse or human ES and iPS cells and Matrigel into immunodeficient mice.
  • the novel method used was shown to be highly reproducible and efficient when 10 6 cells (different from Gropp et al., 2012, which used 10 5 cells) of mouse ES cells and human iPS cells were used.
  • hIDPSC induced pluripotent stem cells from hIDPSC.
  • the pluripotency of hIDPSC derived iPS cells were tested through teratoma formation, while human embryonic stem (ES) cells and hIDPSC were used as control. Routine protocol for teratoma production for ES cells was used (Hentze et al., 2009). Following this protocol 10 6 of cells of each line: hIDPSC-iPS cells, ES cells and hIDPSC were inoculated in the rear leg muscle of 4-week-old male, SCID. In animals, which were inoculated with hIDPSC-iPS cells or ES cells teratoma formation was observed after three months.
  • hIDPSCs which were used as a negative control in this study and were inoculated in 10 animals, did not produce teratomas neither after three month nor after six months of follow-up. Five of these animals were maintained alive during one year and even after this time teratomas formation was not observed.
  • teratoma formation in pluripotent stem cells requires the development of tissues derived from the three germ layers. For adult/me senchymal stem cells, any alterations in the integrity of normal tissue at the site of transplantation were considered. After six months, animals, which were inoculated with hIDPSCs and did not produce teratomas, were killed and histological specimens of the brain, lung, kidney, spleen, and liver were analyzed of the animals. The presence of DNA from hIDPSCs was confirmed in all aforementioned organs but no tumor formation or any morphological alterations were observed. Thus, we established the safety of cell regeneration by investigational product CELLAVITATM (stem cells) regarding tumor formation and risk of immune rejection.
  • CELLAVITATM stem cells
  • FIG. 51 summarizes additional already published preclinical studies, which support the safety of investigational product CELLAVITATM (stem cells).
  • teratoma assay sensitivity and quantitativity; definitive cell number and single cell suspension production; immunophenotyping of studied cell in respect of expression on pluripotent cell markers and karyotype; co-transplantation of studied cells together with Matrigel.
  • the cells were transplanted subcutaneously (s.c) into NOD/SCID mice, which allows for simple monitoring of teratoma development. The development of tumors was monitored from 4 month (-16 weeks). Histological criteria for teratomas is the differentiation of pluripotent cells into the cells derived from three germ layers. Such study usually was performed by pathologist.
  • iPS-IDPSC immature dental pulp stem cells
  • Disclosed multiharvest explant like culture used for the isolation of a population of immature dental pulp stem cells results in expression of embryonic stem cell markers Oct-4, Nanog, SSEA-3, SSEA-4, TRA-1-60 and TRA-1-81 as well as several mesenchymal stem cell markers during at least 15 passages while maintaining the normal karyotype and the rate of expansion characteristic of stem cells.
  • the expression of these markers was maintained in subclones obtained from these cells.
  • in vitro these cells can be induced to undergo uniform differentiation into smooth and skeletal muscles, neurons, cartilage, and bone under chemically defined culture conditions.
  • IDPSC although have a small size and cytoplasm poor in cell organelles differ from naive pluripotent cells presenting typical mesenchymal - fibroblast like morphology. Therefore IDPSC are of mesenchymal type, in contrast to ES and iPS cells, which are of epithelial type.
  • ES and iPS cells which are of epithelial type.
  • MSC and ES or iPS cells synthetize extracellular matrix and are cell junction free cells.
  • this method was validated using dog fetal stem cells from bone marrow, liver, yolk sac, allantois and amniotic liquid which also express pluripotent markers.
  • Wictorin K Wictorin K, Bjorklund A, Williams LR, Varon S, Gage FH: Amelioration of cholinergic neuron atrophy and spatial memory impairment in aged rats by nerve growth factor Nature 1987, 329:65-68
  • Intravenous hMSCs improve myocardial infarction in mice because cells embolized in lung are activated to secrete the antiinflammatory protein TSG-6.

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RU2018134615A RU2742828C2 (ru) 2016-03-09 2017-03-09 Применение стволовых клеток, экспрессирующих мезенхимальные и нейрональные маркеры, и их композиций для лечения неврологических заболеваний (варианты)
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WO2021200744A1 (ja) * 2020-03-31 2021-10-07 Ｃｅｌｌ Ｅｘｏｓｏｍｅ Ｔｈｅｒａｐｅｕｔｉｃｓ株式会社 増殖細胞の生産方法、細胞生産物の生産方法、間葉系幹細胞集団およびその生産方法、幹細胞の培養上清およびその生産方法、並びに治療剤

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